Organization
EXPRESSMED NEW ALBANY , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C BOURLAND (PRESIDENT)
(614) 442-2431
Entity
Organization
Contact information
Practice address
153 W MAIN ST STE 103, NEW ALBANY, OH 43054-9225
(614) 939-9110
(614) 939-4857
Mailing address
2939 KENNY RD STE 200, COLUMBUS, OH 43221-2406
(440) 274-5035
(440) 716-8608
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2338635
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2338635
STATE REGISTRATION
OH
Enumeration date
12/05/2014
Last updated
12/05/2014
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