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General NPI Number Information
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NPI Number | 1073565883
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Entity Type | Organization
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Legal Business Name | SPORTS REHABILITATION CONSULTANTS, INC.
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 01/17/2012
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Provider Practice Location Address
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Address Line | 3866 CARNEGIE AVE
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City | CLEVELAND
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State | OH
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Zip | 44115-2718
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Country | US
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Telephone | 216-621-0022
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Fax | 216-621-5479
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Provider Business Mailing Address
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Address Line | 3866 CARNEGIE AVE
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City | CLEVELAND
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State | OH
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Zip | 44115-2718
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Country | US
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Telephone | 216-621-0022
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Fax | 216-621-5479
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. RUSSELL WEINMAN
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Credential | P.T., A.T.C.
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Telephone | 216-621-0022
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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 |
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License Number State | OH
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