Healthcare Provider Details

I. General information

NPI: 1548652191
Provider Name (Legal Business Name): SPINE FIRST PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2015
Last Update Date: 02/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 RIVERS EDGE DR SUITE 101
COLUMBUS OH
43235-1361
US

IV. Provider business mailing address

3322 WINDY FOREST LN
POWELL OH
43065-7382
US

V. Phone/Fax

Practice location:
  • Phone: 614-406-4622
  • Fax:
Mailing address:
  • Phone: 614-406-4622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number009687
License Number StateOH

VIII. Authorized Official

Name: COREY B URBANSKI
Title or Position: PHYSICAL THERAPIST
Credential: MPT
Phone: 614-406-4622