Provider Demographics
NPI:1073758306
Name:GAITWAY THERAPY LLC
Entity Type:Organization
Organization Name:GAITWAY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CASADY
Authorized Official - Suffix:
Authorized Official - Credentials:PT MS
Authorized Official - Phone:937-935-2594
Mailing Address - Street 1:7403 COUNTY ROAD 101
Mailing Address - Street 2:
Mailing Address - City:BELLE CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43310-9532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7403 COUNTY ROAD 101
Practice Address - Street 2:
Practice Address - City:BELLE CENTER
Practice Address - State:OH
Practice Address - Zip Code:43310-9532
Practice Address - Country:US
Practice Address - Phone:937-935-2594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT44362251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty