Healthcare Provider Details

I. General information

NPI: 1699384347
Provider Name (Legal Business Name): BOTKIN REHAB SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 07/29/2020
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4449 EASTON WAY FL 2
COLUMBUS OH
43219-7005
US

IV. Provider business mailing address

4449 EASTON WAY FL 2
COLUMBUS OH
43219-7005
US

V. Phone/Fax

Practice location:
  • Phone: 614-565-8197
  • Fax:
Mailing address:
  • Phone: 614-565-8197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: RACHEL BOTKIN
Title or Position: CEO
Credential: PT
Phone: 614-565-8197