Healthcare Provider Details

I. General information

NPI: 1174894109
Provider Name (Legal Business Name): TODD S ELCHERT PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2012
Last Update Date: 10/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6880 PERIMETER DR STE A
DUBLIN OH
43016-2521
US

IV. Provider business mailing address

6880 PERIMETER DR STE A
DUBLIN OH
43016-2521
US

V. Phone/Fax

Practice location:
  • Phone: 614-791-0077
  • Fax: 614-791-0011
Mailing address:
  • Phone: 614-791-0077
  • Fax: 614-791-0011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT012476
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: