MEDICARE: PHYSIO THERAPY SOLUTIONS LLC

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	261QP2000X	Physical Therapy Clinic/Center	10642	OH

General Provider Information

NPI Number	:	1750897344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSIO THERAPY SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	8500 STATION ST # 255
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-4943
Country	:	US
Telephone Number	:	440-725-0703
Fax Number	:

Provider Business Practice Location Address
First Line	:	8500 STATION ST # 255
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-4943
Country	:	US
Telephone Number	:	440-725-0703
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHYSICAL THERAPIST
Name	:	MOLLY A STEVENS
Credential	:	DPT
Telephone Number	:	440-725-0703

Provider Enumeration Date	:	12/19/2017
Last Update Date	:	12/19/2017

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Directions to “PHYSIO THERAPY SOLUTIONS LLC ” Practice Location

Language	Start Address	Practice Location

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