Provider Demographics
NPI:1689860330
Name:WOOSTER ORTHOPAEDICS THERAPY
Entity Type:Organization
Organization Name:WOOSTER ORTHOPAEDICS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTTIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-202-3454
Mailing Address - Street 1:3431 COMMERCE PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7114
Mailing Address - Country:US
Mailing Address - Phone:330-345-5166
Mailing Address - Fax:330-345-5042
Practice Address - Street 1:3431 COMMERCE PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7114
Practice Address - Country:US
Practice Address - Phone:330-345-5166
Practice Address - Fax:330-345-5042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT060892251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty