MEDICARE: JAMES SKOCZEN JR. PT

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	PT.013527	OH

General Provider Information

NPI Number	:	1285904011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES SKOCZEN JR. PT

Provider Business Mailing Address
First Line	:	560 N CLEVELAND AVE
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082-9105
Country	:	US
Telephone Number	:	614-839-2300
Fax Number	:	614-839-2301

Provider Business Practice Location Address
First Line	:	560 N CLEVELAND AVE
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082-9105
Country	:	US
Telephone Number	:	614-839-2300
Fax Number	:	614-839-2301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2012
Last Update Date	:	03/10/2015

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