MEDICARE: PT WORKS OF WAPAKONETA INC

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	003724	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	:	1457423816
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PT WORKS OF WAPAKONETA INC

Provider Business Mailing Address
First Line	:	PO BOX 101
Second Line	:
City	:	WAPAKONETA
State	:	OH
Zip	:	45895-0101
Country	:	US
Telephone Number	:	419-738-9675
Fax Number	:	567-356-4334

Provider Business Practice Location Address
First Line	:	410 N DIXIE HWY
Second Line	:
City	:	WAPAKONETA
State	:	OH
Zip	:	45895-7739
Country	:	US
Telephone Number	:	419-738-9675
Fax Number	:	567-356-4334

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SANDRA HUFFMAN
Credential	:	PT
Telephone Number	:	419-738-9675

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	09/21/2016

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Directions to “PT WORKS OF WAPAKONETA INC ” Practice Location

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