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General NPI Number Information
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NPI Number | 1053347716
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Entity Type | Organization
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Legal Business Name | VALLEY PHYSICAL THERAPY SERVICES INC
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 133 MARTHA ST
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City | YORKVILLE
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State | OH
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Zip | 43971
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Country | US
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Telephone | 740-859-5059
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Fax | 740-859-5059
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Provider Business Mailing Address
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Address Line | 631 PUBLIC RD
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City | YORKVILLE
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State | OH
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Zip | 43971
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Country | US
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Telephone | 740-859-5059
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Fax | 740-859-5059
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Authorized Official
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Title or Position | OWNER
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Name | MR. WALTER LATACZ
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Credential | PT
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Telephone | 740-859-5059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1898
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License Number State | OH
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