MEDICARE: PREMIUM HEALTH MANAGEMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT016134	OH

General Provider Information

NPI Number	:	1063902161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIUM HEALTH MANAGEMENT

Provider Business Mailing Address
First Line	:	777 REDWOOD VALLEY DR
Second Line	:
City	:	BLACKLICK
State	:	OH
Zip	:	43004-8830
Country	:	US
Telephone Number	:	330-647-0088
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 REDWOOD VALLEY DR
Second Line	:
City	:	BLACKLICK
State	:	OH
Zip	:	43004-8830
Country	:	US
Telephone Number	:	330-647-0088
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF PHYSICAL THERAPY
Name	:	DR. RYAN ERIC SAYLOR
Credential	:	DPT
Telephone Number	:	330-647-0088

Provider Enumeration Date	:	05/14/2018
Last Update Date	:	05/14/2018

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Directions to “PREMIUM HEALTH MANAGEMENT ” Practice Location

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