Healthcare Provider Details

I. General information

NPI: 1881141018
Provider Name (Legal Business Name): PHYSICAL THERAPY SPECIALISTS OF OHIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2016
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 S HAMILTON RD
GAHANNA OH
43230-3349
US

IV. Provider business mailing address

309 S HAMILTON RD
GAHANNA OH
43230-3349
US

V. Phone/Fax

Practice location:
  • Phone: 614-475-9355
  • Fax: 614-475-9353
Mailing address:
  • Phone: 614-475-9355
  • Fax: 614-475-9353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4269
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13707
License Number StateOH

VIII. Authorized Official

Name: DR. BRIEN MICHAEL HARTINGS
Title or Position: CLINIC DIRECTOR
Credential: DC
Phone: 614-475-9355