Organization
CHARDON PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID NELSON PT, DPT, CIDN (CEO)
(440) 413-6620
Entity
Organization
Contact information
Practice address
357 WASHINGTON ST, CHARDON, OH 44024-1129
(440) 413-6620
Mailing address
12930 WOODIN RD, CHARDON, OH 44024-9135
(440) 413-6620
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT017191
PT LICENSE
OH
Enumeration date
03/01/2021
Last updated
03/01/2021
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