Provider Demographics
NPI:1568460673
Name:ALLIED PHYSICAL REHABILITATIVE SERVICES, INC.
Entity Type:Organization
Organization Name:ALLIED PHYSICAL REHABILITATIVE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER / P.T.
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:P T
Authorized Official - Phone:937-436-2233
Mailing Address - Street 1:357 REGENCY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4252
Mailing Address - Country:US
Mailing Address - Phone:937-436-2233
Mailing Address - Fax:937-291-5530
Practice Address - Street 1:357 REGENCY RIDGE DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4252
Practice Address - Country:US
Practice Address - Phone:937-436-2233
Practice Address - Fax:937-291-5530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT04238225100000X
OHPT02628225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAL9274521Medicare ID - Type UnspecifiedGROUP ID
OHMI0658733Medicare ID - Type UnspecifiedCHARLES MILLER -INDIV
OHMI0658722Medicare ID - Type UnspecifiedSCOTT MILLER -INDIV