Provider Demographics
NPI:1689793143
Name:BILAS PHYSICAL THERAPY, INC.
Entity Type:Organization
Organization Name:BILAS PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:BILAS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:330-757-9772
Mailing Address - Street 1:30 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-1914
Mailing Address - Country:US
Mailing Address - Phone:330-757-9772
Mailing Address - Fax:330-757-7296
Practice Address - Street 1:30 S MAIN ST
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-1914
Practice Address - Country:US
Practice Address - Phone:330-757-9772
Practice Address - Fax:330-757-7296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH155130OtherHEALTH AMERICA
OH000000210442OtherANTHEM
OH155130OtherHEALTH AMERICA
OH155130OtherHEALTH AMERICA