Provider Demographics
NPI:1881141018
Name:PHYSICAL THERAPY SPECIALISTS OF OHIO LLC
Entity type:Organization
Organization Name:PHYSICAL THERAPY SPECIALISTS OF OHIO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HARTINGS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:614-475-9355
Mailing Address - Street 1:309 S HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3349
Mailing Address - Country:US
Mailing Address - Phone:614-475-9355
Mailing Address - Fax:614-475-9353
Practice Address - Street 1:309 S HAMILTON RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3349
Practice Address - Country:US
Practice Address - Phone:614-475-9355
Practice Address - Fax:614-475-9353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13707225100000X
OH4269111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty