Provider Demographics
NPI:1154075190
Name:JOB, PETER THOMAS (PT)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:THOMAS
Last Name:JOB
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 GRANITE CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-3114
Mailing Address - Country:US
Mailing Address - Phone:419-843-6002
Mailing Address - Fax:
Practice Address - Street 1:7150 GRANITE CIR STE 200
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-3114
Practice Address - Country:US
Practice Address - Phone:419-843-6002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT007034225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist