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General NPI Number Information
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NPI Number | 1245989086
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Entity Type | Individual
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Provider Name | JOHN MICHAEL BERNAL PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 730 MOUNT AIRYSHIRE BLVD STE C
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City | COLUMBUS
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State | OH
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Zip | 43235-1364
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Country | US
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Telephone | 614-888-7288
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Fax |
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Provider Business Mailing Address
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Address Line | 15770 NEWCOMB RD
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City | MIDDLEFIELD
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State | OH
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Zip | 44062-8240
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Country | US
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Telephone | 440-635-6433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PT019626
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License Number State | OH
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