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NPI Code Detail

MEDICARE: OHIO PHYSICAL THERAPY SERVICES OF MAYFIELD HEIGHTS, LLC

MEDICARE: OHIO PHYSICAL THERAPY SERVICES OF MAYFIELD HEIGHTS, 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
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1982361598
Entity Type Code : Organization
Provider Name (Legal Business Name) : OHIO PHYSICAL THERAPY SERVICES OF MAYFIELD HEIGHTS, LLC
Provider Business Mailing Address
First Line : PO BOX 51266
Second Line :
City : LAFAYETTE
State : LA
Zip : 70505-1266
Country : US
Telephone Number : 337-233-1307
Fax Number : 337-443-4154
Provider Business Practice Location Address
First Line : 261 RICHMOND RD
Second Line :
City : RICHMOND HEIGHTS
State : OH
Zip : 44143-4422
Country : US
Telephone Number : 440-565-0008
Fax Number : 440-565-0011
Authorized Official
Title or Position : PRESIDENT
Name : JOSHUA L. PROFFITT
Credential :
Telephone Number : 337-233-1307
Provider Enumeration Date : 11/18/2021
Last Update Date : 09/11/2024

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