Healthcare Provider Details

I. General information

NPI: 1720214745
Provider Name (Legal Business Name): WINTERSVILLE MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2009
Last Update Date: 02/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1562 CADIZ ROAD SUITE B
WINTERSVILLE OH
43953
US

IV. Provider business mailing address

1562 CADIZ RD SUITE B
WINTERSVILLE OH
43953-7630
US

V. Phone/Fax

Practice location:
  • Phone: 740-264-1417
  • Fax:
Mailing address:
  • Phone: 740-264-1417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. THADDAUES C SCHRICKEL
Title or Position: PRESIDENT
Credential: DC
Phone: 740-264-6235