Provider Demographics
NPI:1447571468
Name:DRAYER PHYSICAL THERAPY INSTITUTE LLC
Entity Type:Organization
Organization Name:DRAYER PHYSICAL THERAPY INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:717-220-2100
Mailing Address - Street 1:2587 COMMONS BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3841
Mailing Address - Country:US
Mailing Address - Phone:937-426-5555
Mailing Address - Fax:937-426-5556
Practice Address - Street 1:2587 COMMONS BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3841
Practice Address - Country:US
Practice Address - Phone:937-426-5555
Practice Address - Fax:937-426-5556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2013-06-10
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
OH9389661Medicare Oscar/Certification