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General NPI Number Information
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NPI Number | 1437540069
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Entity Type | Organization
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Legal Business Name | SPORTS MEDICINE SPECIALISTS
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Dates
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Enumeration Date | 02/18/2015
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 481 TRACE DR
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City | DELAWARE
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State | OH
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Zip | 43015-7059
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Country | US
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Telephone | 614-432-6401
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Fax |
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Provider Business Mailing Address
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Address Line | 481 TRACE DR
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City | DELAWARE
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State | OH
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Zip | 43015-7059
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Country | US
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Telephone | 614-432-6401
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL SEAN HUFFMAN
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Credential | PT
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Telephone | 614-432-6401
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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 |
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License Number State |
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