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General NPI Number Information
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NPI Number | 1407472004
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Entity Type | Organization
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Legal Business Name | PHYSICAL MEDICINE CENTER OF ST ELIZABETH
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Dates
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Enumeration Date | 06/19/2020
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Last Update Date | 06/19/2020
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Provider Practice Location Address
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Address Line | 1 ELIZABETH PL STE 1100B
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City | DAYTON
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State | OH
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Zip | 45417-3445
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Country | US
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Telephone | 937-813-7666
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Fax | 937-813-7667
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Provider Business Mailing Address
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Address Line | 1 ELIZABETH PL STE 1100B
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City | DAYTON
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State | OH
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Zip | 45417-3445
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Country | US
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Telephone | 937-813-7666
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Fax | 937-813-7667
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Authorized Official
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Title or Position | OWNER
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Name | FUAD AMER
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Credential | DC
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Telephone | 513-213-0919
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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