Provider Demographics
NPI:1518152719
Name:INDUSTRIAL FITNESS
Entity Type:Organization
Organization Name:INDUSTRIAL FITNESS
Other - Org Name:ADVANCED PHYSICAL THERAPY CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEPERA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:614-219-7479
Mailing Address - Street 1:4564 ASHVIEW CT
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8181
Mailing Address - Country:US
Mailing Address - Phone:614-219-7479
Mailing Address - Fax:614-219-7480
Practice Address - Street 1:4555 CEMETERY RD
Practice Address - Street 2:SUITE C
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1102
Practice Address - Country:US
Practice Address - Phone:614-219-7479
Practice Address - Fax:614-219-7480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT04476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHIN9370711Medicare UPIN