Provider Demographics
NPI:1124321773
Name:PRESTIGE PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity type:Organization
Organization Name:PRESTIGE PHYSICAL THERAPY LIMITED PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:2237 CROCKER RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-7605
Mailing Address - Country:US
Mailing Address - Phone:440-617-9600
Mailing Address - Fax:440-617-9608
Practice Address - Street 1:2237 CROCKER RD
Practice Address - Street 2:SUITE 110
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-7605
Practice Address - Country:US
Practice Address - Phone:440-617-9600
Practice Address - Fax:440-617-9608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9394401Medicare PIN