Healthcare Provider Details

I. General information

NPI: 1902947971
Provider Name (Legal Business Name): MARY K ROHRKEMPER AT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2007
Last Update Date: 08/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 AFRICA RD STE 160
WESTERVILLE OH
43082
US

IV. Provider business mailing address

625 AFRICA RD STE 160
WESTERVILLE OH
43082-9808
US

V. Phone/Fax

Practice location:
  • Phone: 614-392-2812
  • Fax: 614-392-2816
Mailing address:
  • Phone: 614-392-2812
  • Fax: 614-392-2816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.008519
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT-000256
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: