Provider Demographics
NPI:1003131368
Name:WILLOUGHBY THERAPY INC
Entity Type:Organization
Organization Name:WILLOUGHBY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-944-5050
Mailing Address - Street 1:30841 EUCLID AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-3100
Mailing Address - Country:US
Mailing Address - Phone:440-944-5050
Mailing Address - Fax:440-944-5250
Practice Address - Street 1:30841 EUCLID AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-3100
Practice Address - Country:US
Practice Address - Phone:440-944-5050
Practice Address - Fax:440-944-5250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty