MEDICARE: UNIVERSITY SPORTS PHYSICAL THERAPY 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

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	:	1467442061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY SPORTS PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	1335 BELMONT AVE
Second Line	:	SUITE 100
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44504-1185
Country	:	US
Telephone Number	:	330-744-7525
Fax Number	:	330-744-0089

Provider Business Practice Location Address
First Line	:	1335 BELMONT AVE
Second Line	:	SUITE 100
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44504-1185
Country	:	US
Telephone Number	:	330-744-7525
Fax Number	:	330-744-0089

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CLAIRE M JONES
Credential	:
Telephone Number	:	330-744-7525

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	04/15/2013

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