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NPI Code Detail

MEDICARE: CHAMPION PHYSICAL THERAPY LLC HALLS

MEDICARE: CHAMPION PHYSICAL THERAPY LLC HALLS
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
1261QR0400XRehabilitation Clinic/Center

General Provider Information

NPI Number : 1396232682
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHAMPION PHYSICAL THERAPY LLC HALLS
Provider Business Mailing Address
First Line : PO BOX 150
Second Line :
City : LIMA
State : OH
Zip : 45802-0150
Country : US
Telephone Number : 419-221-6717
Fax Number : 419-222-0507
Provider Business Practice Location Address
First Line : 7228 NORRIS FWY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37918-5744
Country : US
Telephone Number : 865-377-3176
Fax Number : 865-377-3187
Authorized Official
Title or Position : EXEC VP
Name : STEVE KRZYMINSKI
Credential :
Telephone Number : 419-221-6717
Provider Enumeration Date : 04/23/2018
Last Update Date : 10/12/2023

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