Provider Demographics
NPI:1659403541
Name:SILVERIO PHYSICAL THERAPY
Entity Type:Organization
Organization Name:SILVERIO PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-332-8488
Mailing Address - Street 1:5787 EASTVIEW ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44641-8621
Mailing Address - Country:US
Mailing Address - Phone:330-482-8111
Mailing Address - Fax:
Practice Address - Street 1:2308 SOUTHEAST BLVD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-3418
Practice Address - Country:US
Practice Address - Phone:330-332-8488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0945473Medicaid
OH=========00OtherOHIO BWC NUMBER
OH=========00OtherOHIO BWC NUMBER