# ADVANCE PHYSICAL THERAPY SPORTS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advance Physical Therapy & Sports Medicine LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568576304
- **Authorized official:** GREGORY REIS (PARTNER)
- **Authorized official phone:** (217) 222-6800

## Contact information

- **Practice address:** 225 MAIN ST, KEOKUK, IA 52632-5837
- **Practice address phone:** (319) 524-4900
- **Practice address fax:** (319) 524-4895
- **Mailing address:** 225 MAIN ST, KEOKUK, IA 52632-5837
- **Mailing address phone:** (319) 524-4900
- **Mailing address fax:** (319) 524-4895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/18/2006
- **Last updated:** 05/28/2013