Healthcare Provider Details

I. General information

NPI: 1285904011
Provider Name (Legal Business Name): JAMES SKOCZEN JR. PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2012
Last Update Date: 03/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 N CLEVELAND AVE
WESTERVILLE OH
43082-9105
US

IV. Provider business mailing address

560 N CLEVELAND AVE
WESTERVILLE OH
43082-9105
US

V. Phone/Fax

Practice location:
  • Phone: 614-839-2300
  • Fax: 614-839-2301
Mailing address:
  • Phone: 614-839-2300
  • Fax: 614-839-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.013527
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: