Provider Demographics
NPI:1700086295
Name:TOLEDO SPORTS AND ORTHOPEDIC REHABILITATION INC
Entity Type:Organization
Organization Name:TOLEDO SPORTS AND ORTHOPEDIC REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:419-474-4781
Mailing Address - Street 1:4041 W SYLVANIA AVE
Mailing Address - Street 2:SUITE L004
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4465
Mailing Address - Country:US
Mailing Address - Phone:419-474-4781
Mailing Address - Fax:419-474-8372
Practice Address - Street 1:4041 W SYLVANIA AVE
Practice Address - Street 2:SUITE L004
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4465
Practice Address - Country:US
Practice Address - Phone:419-474-4781
Practice Address - Fax:419-474-8372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty