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General NPI Number Information
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NPI Number | 1396926416
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Entity Type | Organization
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Legal Business Name | NORTHSIDE REHABILITATION
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 150 SPRINGSIDE DRIVE SUITE B250
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City | AKRON
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State | OH
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Zip | 44333-4572
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Country | US
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Telephone | 330-664-1600
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Fax | 330-664-1606
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Provider Business Mailing Address
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Address Line | 150 SPRINGSIDE DRIVE SUITE B250
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City | AKRON
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State | OH
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Zip | 44333-4572
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Country | US
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Telephone | 330-664-1600
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Fax | 330-664-1606
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Authorized Official
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Title or Position | CEO, PRESIDENT
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Name | MR. DAVID B BUTLER
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Credential | MPT
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Telephone | 330-664-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT7378
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License Number State | OH
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