Healthcare Provider Details

I. General information

NPI: 1710022389
Provider Name (Legal Business Name): PORTAGE PHYSICAL THERAPIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 S MAIN ST SUITE 205
AKRON OH
44311-1064
US

IV. Provider business mailing address

388 S MAIN ST SUITE 205
AKRON OH
44311-1064
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-2110
  • Fax:
Mailing address:
  • Phone: 330-543-2110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateOH

VIII. Authorized Official

Name: MRS. DARBIE MATHYS
Title or Position: CEO
Credential:
Phone: 330-297-9020