Organization
ADVANCE THERAPY GROUP PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NYDIA GONZALEZ LOPEZ (DIRECTOR)
(787) 948-2866
Entity
Organization
Contact information
Practice address
STREET 189 MARINA PLAZA, SUITE 17-18, GURABO, PR 00778
(787) 948-2866
(787) 737-6493
Mailing address
HC 1 BOX 26910, CAGUAS, PR 00725-8933
(787) 948-2866
(787) 737-6493
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
763
PR
225X00000X
Occupational Therapist
983
PR
235Z00000X
Speech-Language Pathologist
Primary
1449-1
PR
235Z00000X
Speech-Language Pathologist
824
PR
Other
Enumeration date
07/09/2008
Last updated
11/18/2008
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