Provider Demographics
NPI:1952960676
Name:PEARL PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:PEARL PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-727-1952
Mailing Address - Street 1:7250 WEST BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4346
Mailing Address - Country:US
Mailing Address - Phone:330-992-8080
Mailing Address - Fax:330-992-8081
Practice Address - Street 1:7250 WEST BLVD STE 3
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4346
Practice Address - Country:US
Practice Address - Phone:330-992-8080
Practice Address - Fax:330-992-8081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-06
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy