Basic Information
| Provider Information | |||||||||
| NPI: | 1467116863 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | APOLLO PT LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 844 SLAUGHTER RD STE C | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 357588837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567220555 | ||||||||
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| Practice Location | |||||||||
| Address1: | 844 SLAUGHTER RD STE C | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 357588837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567220555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2021 | ||||||||
| LastUpdateDate: | 10/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | UPTAIN | ||||||||
| AuthorizedOfficialFirstName: | CHASEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2567220555 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.