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NPI Code Detail

MEDICARE: ERIC MARTIN CLEVIDENCE PT

MEDICARE:   ERIC MARTIN CLEVIDENCE  PT
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
12251G0304XGeriatric Physical TherapistPT-012599
22251E1200XErgonomics Physical TherapistPT-012599OH
32251H1200XHand Physical TherapistPT-012599OH
42251H1300XHuman Factors Physical TherapistPT-012599OH
52251S0007XSports Physical TherapistPT-012599OH
62251X0800XOrthopedic Physical TherapistPT-012599OH
7225100000XPhysical TherapistPT-012599OH

General Provider Information

NPI Number : 1912230509
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC MARTIN CLEVIDENCE PT
Provider Business Mailing Address
First Line : 340 POLARIS PKWY
Second Line :
City : WESTERVILLE
State : OH
Zip : 43082-7971
Country : US
Telephone Number : 614-545-7900
Fax Number : 614-545-7901
Provider Business Practice Location Address
First Line : 4611 TRUEMAN BLVD STE B
Second Line :
City : HILLIARD
State : OH
Zip : 43026-2644
Country : US
Telephone Number : 614-340-0683
Fax Number : 614-345-0734
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2009
Last Update Date : 01/06/2025

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