Healthcare Provider Details

I. General information

NPI: 1740479732
Provider Name (Legal Business Name): ERIK VAN DIJK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 FRANKLIN STREET
TORONTO OH
43964-1153
US

IV. Provider business mailing address

1007 FRANKLIN STREET
TORONTO OH
43964-1153
US

V. Phone/Fax

Practice location:
  • Phone: 740-537-2000
  • Fax: 740-537-9440
Mailing address:
  • Phone: 740-537-2000
  • Fax: 740-537-9440

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: ERIK VAN DIJK
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 740-264-5559