Provider Demographics
NPI:1114976024
Name:PHYSICAL THERAPY AND SPORTSCARE CENTERS, INC.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY AND SPORTSCARE CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:330-645-9744
Mailing Address - Street 1:1015 IRONWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5813
Mailing Address - Country:US
Mailing Address - Phone:330-645-9744
Mailing Address - Fax:330-630-9799
Practice Address - Street 1:18 TALLMADGE CIR
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-2305
Practice Address - Country:US
Practice Address - Phone:330-630-0630
Practice Address - Fax:330-630-9799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH003997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty