MEDICARE: FAVOR COMMUNITY SERVICES LLP

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

General Provider Information

NPI Number	:	1578273678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAVOR COMMUNITY SERVICES LLP

Provider Business Mailing Address
First Line	:	7242 DUKE DR
Second Line	:
City	:	CANAL WINCHESTER
State	:	OH
Zip	:	43110-2508
Country	:	US
Telephone Number	:	614-384-6959
Fax Number	:

Provider Business Practice Location Address
First Line	:	7242 DUKE DR
Second Line	:
City	:	CANAL WINCHESTER
State	:	OH
Zip	:	43110-2508
Country	:	US
Telephone Number	:	614-384-6959
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NEEMA EMMANUEL TAMBWE
Credential	:
Telephone Number	:	614-384-6959

Provider Enumeration Date	:	11/29/2022
Last Update Date	:	02/16/2024

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