Organization
ADVANCED THERAPY AND PERFORMANCE LLC
Active
Other names
ATP, ATP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMANUEL LUCIAN BOAR PT, DPT (OWNER - PHYSICAL THERAPIST)
(260) 255-6494
Entity
Organization
Contact information
Practice address
3630 ILLINOIS RD, FORT WAYNE, IN 46804-2062
(260) 255-6494
(260) 399-2075
Mailing address
4106 MERCHANT RD RM A, FORT WAYNE, IN 46818-1248
(260) 255-6494
(260) 399-2075
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/20/2020
Last updated
06/21/2023
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