Provider Demographics
NPI:1619070513
Name:MILLENNIUM REHABILITATION- A PHYSICAL THERAPY AND SPORTS MEDICINE CTR
Entity Type:Organization
Organization Name:MILLENNIUM REHABILITATION- A PHYSICAL THERAPY AND SPORTS MEDICINE CTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:STRAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:330-558-0100
Mailing Address - Street 1:2567 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44233-9561
Mailing Address - Country:US
Mailing Address - Phone:330-558-0100
Mailing Address - Fax:330-558-0110
Practice Address - Street 1:2546 CENTER RD
Practice Address - Street 2:
Practice Address - City:HINCKLEY
Practice Address - State:OH
Practice Address - Zip Code:44233-9561
Practice Address - Country:US
Practice Address - Phone:330-558-0100
Practice Address - Fax:330-558-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2567913Medicaid
OH2567913Medicaid
OHMI9351061Medicare PIN