Organization
ERIE SHORES REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW DAVID MITCHELL OTR (PRESIDENT)
(419) 652-2219
Entity
Organization
Contact information
Practice address
1069 US HIGHWAY 224, NOVA, OH 44859-9770
(419) 652-2219
(419) 652-2219
Mailing address
1069 US HIGHWAY 224, NOVA, OH 44859-9770
(419) 652-2219
(419) 652-2219
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/22/2007
Last updated
09/11/2025
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