Provider Demographics
NPI:1952446916
Name:TOLEDO REHAB GROUP
Entity Type:Organization
Organization Name:TOLEDO REHAB GROUP
Other - Org Name:PROGRESSIVE THERAPY & AQUATIC CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLEMBACH
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:419-479-5960
Mailing Address - Street 1:PO BOX 351705
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43635-1705
Mailing Address - Country:US
Mailing Address - Phone:419-539-7701
Mailing Address - Fax:419-539-7718
Practice Address - Street 1:7640 SYLVANIA AVE
Practice Address - Street 2:SUITE O
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-9729
Practice Address - Country:US
Practice Address - Phone:419-539-7701
Practice Address - Fax:419-539-7718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000364882OtherANTHEM BCBS
OH000000364882OtherANTHEM BCBS