Basic Information
| Provider Information | |||||||||
| NPI: | 1518282474 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | APEX PHYSICAL THERAPY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6320A W UNION HILLS DR | ||||||||
| Address2: | SUITE 265 | ||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853087177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235949034 | ||||||||
| FaxNumber: | 6235949868 | ||||||||
| Practice Location | |||||||||
| Address1: | 20045 N 19TH AVE | ||||||||
| Address2: | BLDG 8 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850274252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235949034 | ||||||||
| FaxNumber: | 6235949868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2010 | ||||||||
| LastUpdateDate: | 11/19/2010 | ||||||||
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| AuthorizedOfficialLastName: | LIHVARCHIK | ||||||||
| AuthorizedOfficialFirstName: | EDWARD | ||||||||
| AuthorizedOfficialMiddleName: | JAMES | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PHYSICAL THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 6235949034 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5513 | AZ | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.