Provider Demographics
NPI:1568688026
Name:HANDS ON PHYSICAL THERAPY OF MENTOR, LLC
Entity Type:Organization
Organization Name:HANDS ON PHYSICAL THERAPY OF MENTOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZIGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:440-255-9553
Mailing Address - Street 1:8836 TYLER BLVD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4361
Mailing Address - Country:US
Mailing Address - Phone:440-255-9553
Mailing Address - Fax:440-255-9563
Practice Address - Street 1:8836 TYLER BLVD
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4361
Practice Address - Country:US
Practice Address - Phone:440-255-9553
Practice Address - Fax:440-255-9563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT065182251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000353899OtherANTHEM GROUP #
OH000000353899OtherANTHEM GROUP #