Organization
INNOVATIVE WORK SOLUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK STEPHEN BASICH P.T. (PRESIDENT)
(740) 671-3188
Entity
Organization
Contact information
Practice address
24 WEST 39TH STREET, ROOM 201, SHADYSIDE, OH 43947
(740) 671-3188
(740) 671-3187
Mailing address
24 WEST 39TH STREET, ROOM 201, SHADYSIDE, OH 43947
(740) 671-3188
(740) 671-3187
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0800577
OH
225100000X
Physical Therapist
0800577
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550777912-00
OHIO BUREAU WORKERS COMP
—
Enumeration date
05/17/2007
Last updated
08/18/2008
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