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General NPI Number Information
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NPI Number | 1073711297
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Entity Type | Organization
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Legal Business Name | WEST BROAD INJURY & REHAB CENTER
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 7634 SLATE RIDGE BLVD
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-8159
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Country | US
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Telephone | 614-367-1203
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Fax | 614-367-1204
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Provider Business Mailing Address
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Address Line | 7634 SLATE RIDGE BLVD
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City | REYNOLDSBURG
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State | OH
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Zip | 43068-8159
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Country | US
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Telephone | 614-367-1203
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Fax | 614-367-1204
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN P SCHEETZ
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Credential | D.C.
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Telephone | 614-367-1203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3331
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License Number State | OH
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