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General NPI Number Information
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NPI Number | 1609639483
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Entity Type | Organization
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Legal Business Name | GROUND UP PHYSICAL THERAPY
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 322 CENTER ST
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City | WHEELERSBURG
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State | OH
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Zip | 45694-1764
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Country | US
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Telephone | 740-935-7285
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Fax |
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Provider Business Mailing Address
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Address Line | 7514 CANTERBURY RD
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City | PORTSMOUTH
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State | OH
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Zip | 45662-5706
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Country | US
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Telephone | 740-935-7285
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACOB WESNEY
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Credential | PT
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Telephone | 740-935-7285
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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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Taxonomy #2
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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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