Healthcare Provider Details

I. General information

NPI: 1790765154
Provider Name (Legal Business Name): OASIS PHYSICAL THERAPY & REH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7810 MCEWEN RD
DAYTON OH
45459-4077
US

IV. Provider business mailing address

7810 MCEWEN RD
DAYTON OH
45459-4077
US

V. Phone/Fax

Practice location:
  • Phone: 937-436-3440
  • Fax: 937-436-3442
Mailing address:
  • Phone: 937-436-3440
  • Fax: 937-436-3442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT10310
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT10310
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT10310
License Number StateOH

VIII. Authorized Official

Name: KAREN SUE GIAMBATTISTA
Title or Position: OWNER
Credential: P.T.
Phone: 937-436-3440