Healthcare Provider Details

I. General information

NPI: 1871313130
Provider Name (Legal Business Name): THOMAS SPAHN STEVEN SPAHN PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 HILL RD N
PICKERINGTON OH
43147-8984
US

IV. Provider business mailing address

826 ELGIN CIR
PICKERINGTON OH
43147-8751
US

V. Phone/Fax

Practice location:
  • Phone: 614-890-6555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA013826
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: