Provider Demographics
NPI:1659649648
Name:ONE STEP FURTHER PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:ONE STEP FURTHER PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, PT
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:330-533-1551
Mailing Address - Street 1:3695 BOARDMAN CANFIELD RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9009
Mailing Address - Country:US
Mailing Address - Phone:330-533-1551
Mailing Address - Fax:330-533-1540
Practice Address - Street 1:3695 BOARDMAN CANFIELD RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9009
Practice Address - Country:US
Practice Address - Phone:330-533-1551
Practice Address - Fax:330-533-1540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH04074225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH366622Medicare UPIN