Provider Demographics
NPI:1740288919
Name:UNIVERSAL THERAPY DYNAMICS, INC
Entity type:Organization
Organization Name:UNIVERSAL THERAPY DYNAMICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:LIUZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-951-6677
Mailing Address - Street 1:35000 KAISER CT
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-3382
Mailing Address - Country:US
Mailing Address - Phone:440-951-6677
Mailing Address - Fax:440-951-2820
Practice Address - Street 1:35000 KAISER CT
Practice Address - Street 2:SUITE 301
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-3382
Practice Address - Country:US
Practice Address - Phone:440-951-6677
Practice Address - Fax:440-951-2820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2660893Medicaid
OH000000166005OtherANTHEM PT
OH000000287889OtherANTHEM OT
OH2660973Medicaid
OH6400134OtherUNITED
OH100644OtherKAISER
OH127841100OtherDOL
OH127841100OtherDOL
OH000000287889OtherANTHEM OT
OH100644OtherKAISER
OH9304631Medicare PIN