Provider Demographics
NPI:1174387732
Name:THE PHYSICAL THERAPY ACADEMY
Entity type:Organization
Organization Name:THE PHYSICAL THERAPY ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, PT
Authorized Official - Phone:301-821-1131
Mailing Address - Street 1:905 N ORLEANS ST UNIT 1001
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-3032
Mailing Address - Country:US
Mailing Address - Phone:301-821-1131
Mailing Address - Fax:
Practice Address - Street 1:1406 W FULTON ST APT 1001
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1145
Practice Address - Country:US
Practice Address - Phone:301-821-1311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy