Provider Demographics
NPI:1184253148
Name:YOUNGSTOWN PHYSICAL REHABILITATION
Entity type:Organization
Organization Name:YOUNGSTOWN PHYSICAL REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:UBRIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-259-9575
Mailing Address - Street 1:5815 MARKET ST STE 6
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-2915
Mailing Address - Country:US
Mailing Address - Phone:330-259-9575
Mailing Address - Fax:330-259-9576
Practice Address - Street 1:5815 MARKET ST STE 6
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-2915
Practice Address - Country:US
Practice Address - Phone:330-259-9575
Practice Address - Fax:330-259-9576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1417348202OtherNPI