Organization
3 PHASE PERFORMANCE THERAPY AND SPORTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SETH M BIDLACK OT (OWNER)
(419) 438-5024
Entity
Organization
Contact information
Practice address
11154 ROAD 230, CECIL, OH 45821-9309
(419) 438-5026
(419) 438-5026
Mailing address
11154 ROAD 230, CECIL, OH 45821-9309
(419) 438-5026
(419) 438-5026
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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