# ADVANCE THERAPY PHYSICAL THERAPY CLINIC, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538192695
- **Authorized official:** SAHAKYAN MARIAM (CEO)
- **Authorized official phone:** (818) 240-5512

## Contact information

- **Practice address:** 1415 E COLORADO ST STE 212, GLENDALE, CA 91205-1541
- **Practice address phone:** (818) 240-5512
- **Mailing address:** 1415 E COLORADO ST STE 212, GLENDALE, CA 91205-1541

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT25149 | CA | Yes |

## Other

- **Enumeration date:** 07/09/2006
- **Last updated:** 08/22/2020