MEDICARE: ACCELERATED MOBILITY PHYSICAL THERAPY LLC

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	225100000X	Physical Therapist
2	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1295887594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCELERATED MOBILITY PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	PO BOX 632656
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-2656
Country	:	US
Telephone Number	:	702-818-5000
Fax Number	:	702-818-5001

Provider Business Practice Location Address
First Line	:	4000 EASTERN SKY DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7351
Country	:	US
Telephone Number	:	231-932-9014
Fax Number	:	231-932-9034

Authorized Official
Title or Position	:	CHIEF CLINICAL OFFICER
Name	:	ERIC DOUGLASS
Credential	:	PT
Telephone Number	:	941-870-4401

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	08/20/2025

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