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General NPI Number Information
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NPI Number | 1831972488
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Entity Type | Organization
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Legal Business Name | SL GREAVES PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 08/17/2023
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 960 N HAMILTON RD STE 104
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City | GAHANNA
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State | OH
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Zip | 43230-3457
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Country | US
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Telephone | 314-221-8252
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Fax |
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Provider Business Mailing Address
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Address Line | 6516 SUMMERS NOOK DR
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City | NEW ALBANY
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State | OH
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Zip | 43054-5011
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Country | US
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Telephone | 314-221-8252
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN GREAVES
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Credential |
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Telephone | 314-221-8252
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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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