Healthcare Provider Details

I. General information

NPI: 1255461638
Provider Name (Legal Business Name): SUBURBAN PHYSICAL THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 S EDGERTON RD
BRECKSVILLE OH
44141-3184
US

IV. Provider business mailing address

2132 CASE PKWY STE A
TWINSBURG OH
44087-2383
US

V. Phone/Fax

Practice location:
  • Phone: 440-746-1730
  • Fax: 440-746-1732
Mailing address:
  • Phone: 330-963-2920
  • Fax: 330-963-2921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: PAULA SMOLENY
Title or Position: ADMINISTRATOR
Credential:
Phone: 330-963-2920