Organization
KEVIN LAURENCE OUTWATER
Active
Other names
PT Ctr for Sports Med-Fam Phys Ther
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA OUTWATER (OFFICE MANAGER)
(330) 239-4186
Entity
Organization
Contact information
Practice address
2660 W MARKET ST, STE 300, FAIRLAWN, OH 44333-4206
(330) 869-2635
(330) 869-8315
Mailing address
2660 W MARKET ST, STE 300, FAIRLAWN, OH 44333-4206
(330) 869-2635
(330) 869-8315
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT04320
OH
Other
Enumeration date
06/14/2005
Last updated
12/19/2014
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