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General NPI Number Information
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NPI Number | 1386875623
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY CONSULTIVE SERVICES
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Dates
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Enumeration Date | 08/04/2009
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Last Update Date | 08/04/2009
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Provider Practice Location Address
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Address Line | 2939 KENNY RD SUITE195
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City | COLUMBUS
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State | OH
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Zip | 43221-2406
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Country | US
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Telephone | 614-459-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 2939 KENNY RD
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City | COLUMBUS
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State | OH
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Zip | 43221-2406
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Country | US
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Telephone | 614-459-2200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK MAHONEY
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Credential | PT
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Telephone | 614-459-2200
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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 | PT-01008
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License Number State | OH
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