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SOUTHERN OHIO SPORTS MEDICINE AND PHYSICAL THERAPY NPI 1700188463


NPI Information

NPI: 1700188463
Provider Name: SOUTHERN OHIO SPORTS MEDICINE AND PHYSICAL THERAPY

Former Legal Business Name: SOUTHERN OHIO SPORTS MEDICINE AND PHYSICAL THERAPY

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
118 RARDEN RD
PEEBLES, OH
ZIP 45660
Phone: (937) 587-9422
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SOUTHERN OHIO SPORTS MEDICINE AND PHYSICAL THERAPY is a specialist in Peebles, OH. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTHERN OHIO SPORTS MEDICINE AND PHYSICAL THERAPY NPI is 1700188463. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Southern Ohio Sports Medicine And Physical Therapy.

The provider's business location address is:

118 RARDEN RD
PEEBLES, OH
ZIP 45660-049
Phone: (937) 587-9422
Fax: (937) 587-9522

The provider's authorized official is Melissa Mae Waddell .
The authorized official title is Physical Therapist and has the following contact phone number (937) 587-9422.

The enumeration date for this NPI number is 11/30/2010 and was last updated on 11/30/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistPT 5740OHIOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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