Provider Demographics
NPI:1447973219
Name:ADVANTAGE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:ADVANTAGE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANFEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-420-0585
Mailing Address - Street 1:44604 STERLING HWY STE D
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7962
Mailing Address - Country:US
Mailing Address - Phone:907-420-0585
Mailing Address - Fax:907-420-0586
Practice Address - Street 1:44009 STERLING HWY STE B
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-8030
Practice Address - Country:US
Practice Address - Phone:907-420-0585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy