MEDICARE: ADVANCED CENTER FOR PHYSICAL THERAPY, PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center	8658	VA

General Provider Information

NPI Number	:	1013169473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED CENTER FOR PHYSICAL THERAPY, PLC

Provider Business Mailing Address
First Line	:	PO BOX 392573
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251-9573
Country	:	US
Telephone Number	:	724-584-5739
Fax Number	:

Provider Business Practice Location Address
First Line	:	5928 SEMINOLE TRL
Second Line	:	SUITE 103
City	:	BARBOURSVILLE
State	:	VA
Zip	:	22923-2831
Country	:	US
Telephone Number	:	434-985-2198
Fax Number	:	434-985-3227

Authorized Official
Title or Position	:	DIRECTOR OF CREDENTIALING
Name	:	LAUREN LAU
Credential	:
Telephone Number	:	724-989-4564

Provider Enumeration Date	:	10/16/2008
Last Update Date	:	01/13/2021

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