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NPI Code Detail

MEDICARE: LAURA GERUNTINO WIDDOWS DPT

MEDICARE: LAURA GERUNTINO WIDDOWS DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT01633OH

General Provider Information

NPI Number : 1528559101
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA GERUNTINO WIDDOWS DPT
Provider Business Mailing Address
First Line : 4605 SAWMILL RD
Second Line :
City : UPPER ARLINGTON
State : OH
Zip : 43220-2246
Country : US
Telephone Number : 614-827-8702
Fax Number : 614-827-8703
Provider Business Practice Location Address
First Line : 10104 BREWSTER LN STE 180
Second Line :
City : POWELL
State : OH
Zip : 43065-7578
Country : US
Telephone Number : 614-827-8700
Fax Number : 614-827-8701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2018
Last Update Date : 11/15/2019

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Directions to “ LAURA GERUNTINO WIDDOWS DPT” Practice Location

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