Provider Demographics
NPI:1659862761
Name:ORION SPORTS MEDICINE LLC
Entity Type:Organization
Organization Name:ORION SPORTS MEDICINE LLC
Other - Org Name:ORION PHYSICAL THERAPY SPECIALISTS
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:ANLOAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DHSC, OCS, MTC
Authorized Official - Phone:937-227-3174
Mailing Address - Street 1:2042 BYERS RD
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2042 BYERS RD
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342
Practice Address - Country:US
Practice Address - Phone:937-227-3174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORION PHYSICAL THERAPY SPECIALISTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-24
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty