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General NPI Number Information
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NPI Number | 1952591240
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Entity Type | Organization
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Legal Business Name | PLUS SPORTS INC
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Dates
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Enumeration Date | 08/01/2007
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Last Update Date | 08/01/2007
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Provider Practice Location Address
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Address Line | 216 HIGHLAND AVE
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City | CAMBRIDGE
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State | OH
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Zip | 43725-2528
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Country | US
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Telephone | 740-435-8181
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Fax |
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Provider Business Mailing Address
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Address Line | 216 HIGHLAND AVE
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City | CAMBRIDGE
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State | OH
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Zip | 43725-2528
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Country | US
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Telephone | 740-435-8181
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER CFO
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Name | JULIE LAISHLEY
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Credential |
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Telephone | 740-435-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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