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General NPI Number Information
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NPI Number | 1194093435
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Entity Type | Organization
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Legal Business Name | SUMMIT REHABILITATION SERVICES, LLC
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 3715 WILLISTON RD
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City | NORTHWOOD
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State | OH
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Zip | 43619-2001
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Country | US
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Telephone | 419-698-2500
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Fax | 419-698-2504
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Provider Business Mailing Address
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Address Line | 3715 WILLISTON RD
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City | NORTHWOOD
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State | OH
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Zip | 43619-2001
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Country | US
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Telephone | 419-698-2500
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Fax | 419-698-2504
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Authorized Official
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Title or Position | DIRECTOR OF PHYSICAL THERAPY
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Name | NICHOLAS M ENCHEFF
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Credential | PT, ATC
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Telephone | 419-698-2500
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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 | PT05829
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License Number State | OH
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