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Organization
MARYSVILLE PHYSICAL THERAPY INC
Active
Organization
MARYSVILLE PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY L WOOD (OFFICE MANAGER)
(937) 644-3311
Entity
Organization
Contact information
Practice address
211 STOCKSDALE DR, MARYSVILLE, OH 43040-5507
(937) 644-3311
(937) 644-0373
Mailing address
211 STOCKSDALE DR, MARYSVILLE, OH 43040-5507
(937) 644-3311
(937) 644-0373
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 004515
OH
2251H1200X
Hand Physical Therapist
9611000450
OH
2251X0800X
Orthopedic Physical Therapist
PT 004515
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000161895
ANTHEM GROUP NUMBER
OH
01
—
15668
NATIONWIDE INSURANCE NUMB
OH
01
—
23-2804807
REHAB PROVIDER NETWORK NU
OH
05
—
2614531
—
OH
01
—
685840
UNITED HEALTHCARE GROUP
OH
Enumeration date
11/28/2005
Last updated
06/21/2018
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