Healthcare Provider Details

I. General information

NPI: 1982513842
Provider Name (Legal Business Name): SOPHIA VARGO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 PALMETTO ST
COLUMBUS OH
43228-1733
US

IV. Provider business mailing address

5050 PALMETTO ST
COLUMBUS OH
43228-1733
US

V. Phone/Fax

Practice location:
  • Phone: 614-897-0823
  • Fax:
Mailing address:
  • Phone: 614-897-0823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT022591
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: