Healthcare Provider Details

I. General information

NPI: 1447061163
Provider Name (Legal Business Name): FLESHER PHYSIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 RIVER VALLEY BLVD
LANCASTER OH
43130-1653
US

IV. Provider business mailing address

PO BOX 536
GRANVILLE OH
43023-0536
US

V. Phone/Fax

Practice location:
  • Phone: 740-303-4300
  • Fax: 740-303-4313
Mailing address:
  • Phone: 614-464-7288
  • Fax: 740-587-1362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: TMOTHY FLESHER
Title or Position: OWNER
Credential: MD
Phone: 614-464-7288