Organization
PODIUM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED BONECUTTER PT, DPT (PRESIDENT)
(419) 982-0062
Entity
Organization
Contact information
Practice address
20 E MADISON AVE, SHELBY, OH 44875-1614
(419) 982-0062
Mailing address
20 E MADISON AVE, SHELBY, OH 44875-1614
(419) 982-0062
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT016306
OH
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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