Healthcare Provider Details

I. General information

NPI: 1790141802
Provider Name (Legal Business Name): REHABILITATION AQUATICS AND PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2016
Last Update Date: 01/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 CENTRAL PARK W SUITE A
TOLEDO OH
43617-1094
US

IV. Provider business mailing address

3130 CENTRAL PARK W SUITE A
TOLEDO OH
43617-1094
US

V. Phone/Fax

Practice location:
  • Phone: 419-841-9622
  • Fax: 419-843-8288
Mailing address:
  • Phone: 419-841-9622
  • Fax: 419-843-8288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number707224
License Number StateOH

VIII. Authorized Official

Name: MRS. CINDY MARIE BINKLEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 419-841-9622