Provider Demographics
NPI:1942450622
Name:SYNERGY PHYSICAL THERAPY AND WELLNESS, LLC
Entity Type:Organization
Organization Name:SYNERGY PHYSICAL THERAPY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-997-0014
Mailing Address - Street 1:4510 COLLINS BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-6954
Mailing Address - Country:US
Mailing Address - Phone:440-997-0014
Mailing Address - Fax:440-998-7032
Practice Address - Street 1:4510 COLLINS BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-6954
Practice Address - Country:US
Practice Address - Phone:440-997-0014
Practice Address - Fax:440-998-7032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy