Healthcare Provider Details

I. General information

NPI: 1265772925
Provider Name (Legal Business Name): GENESIS REHAB SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2013
Last Update Date: 02/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 NORTH MAIN STREET
WESTERVILLE OH
43081
US

IV. Provider business mailing address

140 NORTH MAIN STREET
WESTERVILLE OH
43081
US

V. Phone/Fax

Practice location:
  • Phone: 614-882-4055
  • Fax:
Mailing address:
  • Phone: 614-882-4055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberPT.013862
License Number StateOH

VIII. Authorized Official

Name: DR. CHELSEY ORR
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 614-882-4055