MEDICARE: AUGUSTA PHYSICAL THERAPY PC

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
2	261QP2000X	Physical Therapy Clinic/Center	0119000914	VA

General Provider Information

NPI Number	:	1518993971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUGUSTA PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	424 COMMERCE RD
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24401-4432
Country	:	US
Telephone Number	:	540-887-8007
Fax Number	:	540-908-3901

Provider Business Practice Location Address
First Line	:	424 COMMERCE RD
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24401-4432
Country	:	US
Telephone Number	:	540-887-8007
Fax Number	:	540-908-3901

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALAN SCOTT REITZ
Credential	:	P.T.
Telephone Number	:	540-887-8007

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	12/09/2015

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