Provider Demographics
NPI:1780910018
Name:DYNAMIC THERAPEUTIC SERVICES OF OHIO
Entity type:Organization
Organization Name:DYNAMIC THERAPEUTIC SERVICES OF OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-820-2100
Mailing Address - Street 1:147 BELL ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-2982
Mailing Address - Country:US
Mailing Address - Phone:440-318-1101
Mailing Address - Fax:866-879-3128
Practice Address - Street 1:147 BELL ST
Practice Address - Street 2:SUITE 304
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-2982
Practice Address - Country:US
Practice Address - Phone:440-318-1101
Practice Address - Fax:866-879-3128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency