MEDICARE: ADVANCED CARE PHYSICAL THERAPY PLLC

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	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1285769034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED CARE PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	411 W RD 1 NORTH
Second Line	:	STE A
City	:	CHINO VALLEY
State	:	AZ
Zip	:	86323-0520
Country	:	US
Telephone Number	:	928-636-8521
Fax Number	:	928-636-8591

Provider Business Practice Location Address
First Line	:	411 W RD 1 NORTH
Second Line	:	STE A
City	:	CHINO VALLEY
State	:	AZ
Zip	:	86323-0520
Country	:	US
Telephone Number	:	928-636-8521
Fax Number	:	928-636-8591

Authorized Official
Title or Position	:	OWNER PT
Name	:	MRS. JANE SCIMECA
Credential	:	PT
Telephone Number	:	928-636-8521

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	03/18/2015

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