Healthcare Provider Details

I. General information

NPI: 1689793143
Provider Name (Legal Business Name): BILAS PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 S MAIN ST
POLAND OH
44514-1914
US

IV. Provider business mailing address

30 S MAIN ST
POLAND OH
44514-1914
US

V. Phone/Fax

Practice location:
  • Phone: 330-757-9772
  • Fax: 330-757-7296
Mailing address:
  • Phone: 330-757-9772
  • Fax: 330-757-7296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. DENNIS J BILAS
Title or Position: PRESIDENT
Credential: PT
Phone: 330-757-9772