Organization
ATHLETIC DYNAMICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK VANLEUVEN PT CSCS (OWNER CHIEF OPERATING OFFICER)
(518) 641-6775
Entity
Organization
Contact information
Practice address
7 SOUTHWOODS BLVD, 4TH FL, ATHLETIC DYNAMICS LLC, ALBANY, NY 12211-2526
(518) 641-6775
(518) 292-6085
Mailing address
7 SOUTHWOODS BLVD, 4TH FL, ATHLETIC DYNAMICS LLC C/O CAPITOL CARDIOLOGY ASSOC, ALBANY, NY 12211-2526
(518) 641-6775
(518) 292-6085
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02251054
—
NY
Enumeration date
03/22/2006
Last updated
11/27/2007
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