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General NPI Number Information
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NPI Number | 1457881740
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Entity Type | Organization
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Legal Business Name | BEDFORD PHYSICAL THERAPY & FITNESS SERVICES LLC
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 06/19/2017
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Provider Practice Location Address
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Address Line | 2 BEREA COMMONS STE 10
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City | BEREA
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State | OH
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Zip | 44017-2535
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Country | US
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Telephone | 240-620-5819
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Fax |
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Provider Business Mailing Address
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Address Line | 541 FAIR ST
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City | BEREA
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State | OH
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Zip | 44017-2656
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM BEDFORD II
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Credential | PT, DPT
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Telephone | 240-620-5819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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