Provider Demographics
NPI:1932518214
Name:OHIO SPINE AND BODY 2, LLC
Entity Type:Organization
Organization Name:OHIO SPINE AND BODY 2, LLC
Other - Org Name:OHIO SPINE AND BODY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHERROD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-822-6759
Mailing Address - Street 1:69 LINCOLN BLVD
Mailing Address - Street 2:A262
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-6303
Mailing Address - Country:US
Mailing Address - Phone:440-324-1334
Mailing Address - Fax:
Practice Address - Street 1:10198 SPRINGFIELD PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-1448
Practice Address - Country:US
Practice Address - Phone:513-772-9066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty