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General NPI Number Information
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NPI Number | 1003289174
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Entity Type | Organization
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Legal Business Name | P T SERVICES REHABILITATION INC
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 2550 S STATE ROUTE 100
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City | TIFFIN
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State | OH
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Zip | 44883-9356
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Country | US
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Telephone | 419-447-7203
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 833
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City | TIFFIN
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State | OH
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Zip | 44883-0833
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARK SOMODI
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Credential |
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Telephone | 419-447-7203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 4945
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License Number State | OH
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