Provider Demographics
NPI:1366495897
Name:OHIO VESTIBULAR & BALANCE CENTERS INC
Entity Type:Organization
Organization Name:OHIO VESTIBULAR & BALANCE CENTERS INC
Other - Org Name:BALANCE AND BODY REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:419-841-3477
Mailing Address - Street 1:PO BOX 514
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528
Mailing Address - Country:US
Mailing Address - Phone:419-841-3477
Mailing Address - Fax:419-841-3434
Practice Address - Street 1:3335 MEIJER DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-3104
Practice Address - Country:US
Practice Address - Phone:419-841-3477
Practice Address - Fax:419-841-3434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH366742Medicare Oscar/Certification