Provider Demographics
NPI:1760650378
Name:PEDIATRIC THERAPY SPECIALISTS OF GROVE CITY
Entity Type:Organization
Organization Name:PEDIATRIC THERAPY SPECIALISTS OF GROVE CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PRESTON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:614-875-9100
Mailing Address - Street 1:3142 BROADWAY
Mailing Address - Street 2:SUTIE 206
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-1780
Mailing Address - Country:US
Mailing Address - Phone:614-875-9100
Mailing Address - Fax:614-875-9145
Practice Address - Street 1:3142 BROADWAY
Practice Address - Street 2:SUITE 206
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-1780
Practice Address - Country:US
Practice Address - Phone:614-875-9100
Practice Address - Fax:614-875-9145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-16
Last Update Date:2008-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT5416225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty