Provider Demographics
NPI:1992033377
Name:SPORTS THERAPY OF COLUMBUS, LLC
Entity Type:Organization
Organization Name:SPORTS THERAPY OF COLUMBUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:BARTHOLOMEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-515-5672
Mailing Address - Street 1:8080 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-6477
Mailing Address - Country:US
Mailing Address - Phone:614-515-5672
Mailing Address - Fax:614-515-5673
Practice Address - Street 1:8080 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-6477
Practice Address - Country:US
Practice Address - Phone:614-515-5672
Practice Address - Fax:614-515-5673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty