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General NPI Number Information
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NPI Number | 1629671003
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Entity Type | Organization
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Legal Business Name | OUTPATIENT AT HOME LLC
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 965 HIGH ST
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City | WORTHINGTON
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State | OH
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Zip | 43085-4057
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Country | US
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Telephone | 419-564-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 965 HIGH ST
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City | WORTHINGTON
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State | OH
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Zip | 43085-4057
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Country | US
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Telephone | 419-564-2500
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Fax |
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Authorized Official
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Title or Position | SENIOR ADVISOR
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Name | JASON ROLLER
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Credential |
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Telephone | 419-564-2500
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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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