Provider Demographics
NPI:1982254942
Name:OHIO VALLEY SPORTS AND PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:OHIO VALLEY SPORTS AND PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRYNIARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:740-338-9698
Mailing Address - Street 1:520 W 41ST ST
Mailing Address - Street 2:
Mailing Address - City:SHADYSIDE
Mailing Address - State:OH
Mailing Address - Zip Code:43947-1171
Mailing Address - Country:US
Mailing Address - Phone:740-232-4707
Mailing Address - Fax:
Practice Address - Street 1:520 W 41ST ST
Practice Address - Street 2:
Practice Address - City:SHADYSIDE
Practice Address - State:OH
Practice Address - Zip Code:43947-1171
Practice Address - Country:US
Practice Address - Phone:740-232-4707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy