Provider Demographics
NPI:1619398120
Name:SOUTH TOLEDO PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:SOUTH TOLEDO PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-367-3597
Mailing Address - Street 1:3318 GLANZMAN RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3856
Mailing Address - Country:US
Mailing Address - Phone:419-380-9166
Mailing Address - Fax:419-380-9316
Practice Address - Street 1:3318 GLANZMAN RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-3856
Practice Address - Country:US
Practice Address - Phone:419-380-9166
Practice Address - Fax:419-380-9316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-31
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT005091261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy