Provider Demographics
NPI:1356744957
Name:FOCUS PHYSICAL THERAPY AND SPORTS MEDICINE LLC
Entity type:Organization
Organization Name:FOCUS PHYSICAL THERAPY AND SPORTS MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CODY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:614-565-5036
Mailing Address - Street 1:6350 NEEDLETAIL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6450
Mailing Address - Country:US
Mailing Address - Phone:614-565-5036
Mailing Address - Fax:
Practice Address - Street 1:6350 NEEDLETAIL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-6450
Practice Address - Country:US
Practice Address - Phone:614-565-5036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-27
Last Update Date:2014-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center