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General NPI Number Information
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NPI Number | 1902086580
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Entity Type | Organization
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Legal Business Name | NORTH SUMMIT PHYSICAL THERAPY AND ATHLETIC EDGE, INC
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 11/21/2007
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Provider Practice Location Address
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Address Line | 9945 VAIL DR SUITE 4
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City | TWINSBURG
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State | OH
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Zip | 44087-4900
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Country | US
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Telephone | 330-405-3343
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Fax | 330-487-1093
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Provider Business Mailing Address
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Address Line | 9945 VAIL DR SUITE 4
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City | TWINSBURG
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State | OH
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Zip | 44087-4900
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Country | US
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Telephone | 330-405-3343
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Fax | 330-487-1093
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | TIMOTHY LOUIS ALESNIK
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Credential | PT, ATC
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Telephone | 330-771-0860
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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 | PT 07828
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License Number State | OH
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