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NPI Code Detail

MEDICARE: DR. JOHN MICHAEL BERNAL PT, DPT

MEDICARE: DR. JOHN MICHAEL BERNAL PT, DPT
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
1225100000XPhysical TherapistPT019626OH

General Provider Information

NPI Number : 1245989086
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN MICHAEL BERNAL PT, DPT
Provider Business Mailing Address
First Line : 15770 NEWCOMB RD
Second Line :
City : MIDDLEFIELD
State : OH
Zip : 44062-8240
Country : US
Telephone Number : 440-635-6433
Fax Number :
Provider Business Practice Location Address
First Line : 730 MOUNT AIRYSHIRE BLVD STE C
Second Line :
City : COLUMBUS
State : OH
Zip : 43235-1364
Country : US
Telephone Number : 614-888-7288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2022
Last Update Date : 03/29/2022

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