Healthcare Provider Details

I. General information

NPI: 1578397337
Provider Name (Legal Business Name): MIDWEST FEDERAL INJURY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 E ALEX BELL RD STE 212
CENTERVILLE OH
45459-2794
US

IV. Provider business mailing address

175 E ALEX BELL RD STE 212
CENTERVILLE OH
45459-2794
US

V. Phone/Fax

Practice location:
  • Phone: 513-783-2560
  • Fax:
Mailing address:
  • Phone: 508-243-1563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name: LAURA GIAMPA
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 508-243-1563