MEDICARE: APEX 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	261QX0100X	Occupational Medicine Clinic/Center
2	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1376590307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APEX PHYSICAL THERAPY, LLC

Provider Business Mailing Address
First Line	:	15 APEX DR
Second Line	:
City	:	HIGHLAND
State	:	IL
Zip	:	62249-1282
Country	:	US
Telephone Number	:	618-651-0444
Fax Number	:	618-654-5439

Provider Business Practice Location Address
First Line	:	2136 VADALABENE DR
Second Line	:	SUITE D
City	:	MARYVILLE
State	:	IL
Zip	:	62062-5632
Country	:	US
Telephone Number	:	618-288-4677
Fax Number	:	618-288-4699

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MR. BRADLEY R. PFITZNER
Credential	:	OTR/L
Telephone Number	:	618-651-0444

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	10/08/2015

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