Provider Demographics
NPI:1245914662
Name:WALTHOUR, COLIN B (DPT)
Entity type:Individual
Prefix:MR
First Name:COLIN
Middle Name:B
Last Name:WALTHOUR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 W NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45315-9505
Mailing Address - Country:US
Mailing Address - Phone:937-832-8982
Mailing Address - Fax:
Practice Address - Street 1:1250 W NATIONAL RD STE 200
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45315-9506
Practice Address - Country:US
Practice Address - Phone:937-832-8982
Practice Address - Fax:937-832-8973
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0151552251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic