MEDICARE: MR. MARK A READ LPT

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	2251S0007X	Sports Physical Therapist	PT 004253	OH
2	2251X0800X	Orthopedic Physical Therapist	PT 004253	OH
3	2251S0007X	Sports Physical Therapist	PT004253	OH
4	2251X0800X	Orthopedic Physical Therapist	PT004253	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326034299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARK A READ LPT

Provider Business Mailing Address
First Line	:	8849 WHITNEY DRIVE
Second Line	:
City	:	LEWIS CENTER
State	:	OH
Zip	:	43035-7107
Country	:	US
Telephone Number	:	740-549-7041
Fax Number	:	740-549-7045

Provider Business Practice Location Address
First Line	:	8849 WHITNEY DRIVE
Second Line	:
City	:	LEWIS CENTER
State	:	OH
Zip	:	43035-7107
Country	:	US
Telephone Number	:	740-549-7041
Fax Number	:	740-549-7045

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	12/03/2012

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Directions to “ MR. MARK A READ LPT” Practice Location

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