Healthcare Provider Details

I. General information

NPI: 1134328347
Provider Name (Legal Business Name): SPRINGFIELD PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 GRUBE ST
SPRINGFIELD OH
45503-2642
US

IV. Provider business mailing address

2221 GRUBE ST
SPRINGFIELD OH
45503-2642
US

V. Phone/Fax

Practice location:
  • Phone: 937-399-8941
  • Fax: 937-399-5639
Mailing address:
  • Phone: 937-399-8941
  • Fax: 937-399-5639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JORDAN A HOUSEMAN
Title or Position: PRESIDENT
Credential: PT,DPT,OTR/L,MOT
Phone: 937-399-8941