Provider Demographics
NPI:1801277322
Name:PT LINK AT SOUTH TOLEDO, LLC
Entity type:Organization
Organization Name:PT LINK AT SOUTH TOLEDO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:HALLETT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:419-559-5591
Mailing Address - Street 1:7071 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-2700
Mailing Address - Country:US
Mailing Address - Phone:419-843-1370
Mailing Address - Fax:419-843-8402
Practice Address - Street 1:3318 GLANZMAN RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-3856
Practice Address - Country:US
Practice Address - Phone:419-380-9316
Practice Address - Fax:419-380-9166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-10
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty