Provider Demographics
NPI:1568706703
Name:MARYBETH F. ROMEO, PT LLC
Entity Type:Organization
Organization Name:MARYBETH F. ROMEO, PT LLC
Other - Org Name:CENTER FOR PHYSICAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST / CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARYBETH
Authorized Official - Middle Name:F
Authorized Official - Last Name:ROMEO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:330-921-9307
Mailing Address - Street 1:4137 BOARDMAN CANFIELD RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-8087
Mailing Address - Country:US
Mailing Address - Phone:330-286-3850
Mailing Address - Fax:330-286-3852
Practice Address - Street 1:4137 BOARDMAN CANFIELD RD
Practice Address - Street 2:SUITE 104
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-8087
Practice Address - Country:US
Practice Address - Phone:330-286-3850
Practice Address - Fax:330-286-3852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-10
Last Update Date:2012-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOHPT07844261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy