Provider Demographics
NPI:1043757750
Name:ONE TO ONE PHYSICAL THERAPY AND PILATES FITNESS LLC
Entity Type:Organization
Organization Name:ONE TO ONE PHYSICAL THERAPY AND PILATES FITNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:TAKISHIMA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:614-314-5773
Mailing Address - Street 1:3805 N HIGH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3539
Mailing Address - Country:US
Mailing Address - Phone:614-259-3324
Mailing Address - Fax:614-636-4582
Practice Address - Street 1:3805 N HIGH ST STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3539
Practice Address - Country:US
Practice Address - Phone:614-259-3324
Practice Address - Fax:614-636-4582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-20
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0131258Medicaid