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NPI Code Detail

MEDICARE: ANTONINE THERAPY CENTER

MEDICARE: ANTONINE THERAPY CENTER
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
1261QP2000XPhysical Therapy Clinic/CenterOH

General Provider Information

NPI Number : 1528451432
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANTONINE THERAPY CENTER
Provider Business Mailing Address
First Line : 2675 N LIPKEY RD
Second Line :
City : NORTH JACKSON
State : OH
Zip : 44451-9665
Country : US
Telephone Number : 330-538-9822
Fax Number : 330-538-9820
Provider Business Practice Location Address
First Line : 2675 N LIPKEY RD
Second Line :
City : NORTH JACKSON
State : OH
Zip : 44451-9665
Country : US
Telephone Number : 330-538-9822
Fax Number : 330-538-9820
Authorized Official
Title or Position : PRESIDENT
Name : MARIE MADELEINE ISKANDAR
Credential :
Telephone Number : 330-538-9822
Provider Enumeration Date : 03/17/2015
Last Update Date : 03/17/2015

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Directions to “ANTONINE THERAPY CENTER ” Practice Location

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