Healthcare Provider Details

I. General information

NPI: 1770804825
Provider Name (Legal Business Name): TROY PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2010
Last Update Date: 11/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W FRANKLIN ST
TROY OH
45373-3209
US

IV. Provider business mailing address

693 WILLOW POINT CT
TROY OH
45373-8623
US

V. Phone/Fax

Practice location:
  • Phone: 937-901-3480
  • Fax: 937-980-9125
Mailing address:
  • Phone: 937-901-3480
  • Fax: 937-980-9125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. TODD CHARLES MILLER
Title or Position: OWNER
Credential: PHYSICAL THERAPIST
Phone: 937-901-3480