Healthcare Provider Details

I. General information

NPI: 1356721815
Provider Name (Legal Business Name): CELLER O'TOOLE, PT. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2015
Last Update Date: 05/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2862 E MAIN ST SUITE B
COLUMBUS OH
43209-3709
US

IV. Provider business mailing address

140 HOLDER RD NE
BALTIMORE OH
43105-9710
US

V. Phone/Fax

Practice location:
  • Phone: 614-578-8706
  • Fax:
Mailing address:
  • Phone: 614-578-8706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number2892
License Number StateOH

VIII. Authorized Official

Name: MRS. CELLER YING O'TOOLE
Title or Position: PRESIDENT
Credential: PT
Phone: 614-578-8706