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Organization

COMMONWEALTH REHABILITATION AND SPORTS MEDICINE, P.S.C.

Active
Other names
Heartland Sports Medicine & Rehabilitation
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT MCCRAY PT (CHIEF OPERATING OFFICER)
(419) 537-0764
Entity
Organization

Contact information

Practice address
193 GLADES RD, BEREA, KY 40403-1369
(859) 986-1055
(859) 986-1002
Mailing address
3425 EXECUTIVE PARKWAY, TOLEDO, OH 43606-1333
(419) 537-0764
(419) 537-0948

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
412190836-02
OHIO BWC
01
611270800
DEPARTMENT OF LABOR/OWCP
05
8790053600
KY
Enumeration date
05/25/2006
Last updated
10/04/2010
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