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General NPI Number Information
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NPI Number | 1790646735
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Entity Type | Organization
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Legal Business Name | ELUMINA REHAB
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 1103 SCHROCK RD STE 201
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City | COLUMBUS
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State | OH
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Zip | 43229-1179
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Country | US
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Telephone | 888-860-0333
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Fax | 888-645-0333
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Provider Business Mailing Address
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Address Line | 1103 SCHROCK RD STE 201
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City | COLUMBUS
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State | OH
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Zip | 43229-1179
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Country | US
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Telephone | 888-860-0333
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Fax | 888-645-0333
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Authorized Official
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Title or Position | SVP
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Name | KIM FERGUSON
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Credential |
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Telephone | 740-352-8113
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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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