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Organization
PHYSIOSOURCE LTD.
Active
Organization
PHYSIOSOURCE LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOANNE D SHERMAN P.T. (OWNER)
(419) 724-5580
Entity
Organization
Contact information
Practice address
3840 WOODLEY RD., SUITE D, TOLEDO, OH 43606-1178
(419) 724-5580
(419) 724-5581
Mailing address
PO BOX 878, SYLVANIA, OH 43560-0878
(419) 724-5580
(419) 724-5581
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT07759
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000285765
ANTHEM BC/BS
OH
05
—
2419743
—
OH
01
—
362488800
DEPARTMENT OF LABOR
OH
01
—
498394182
MEDICAL MUTUAL OF OHIO
OH
01
—
731071
BUCKEYE COMMUNITY HEALTH
OH
01
—
DD2140
RAILROAD MEDICARE
OH
Enumeration date
07/15/2006
Last updated
03/28/2019
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