Organization
ADVANTAGE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TARKIO CHESTER (MEMBER)
(740) 333-7848
Entity
Organization
Contact information
Practice address
1392 RAWLINGS ST, WSHNGTN CT HS, OH 43160-1985
(740) 333-7848
(740) 333-1212
Mailing address
1392 RAWLINGS ST, WSHNGTN CT HS, OH 43160-1985
(740) 333-7848
(740) 333-1212
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000380490
ANTHEM BC AND BS
—
05
—
2636839
—
OH
01
—
696307
ACN GRP-UNITED HEALTHCARE
—
Enumeration date
04/24/2007
Last updated
11/19/2010
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