Organization
CHAMPION PHYSICAL THERAPY LLC HALLS
Active
Other names
CORA Physical Therapy - Harriman
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD C ROUSH (EXECUTIVE VICE PRESIDENT)
(419) 221-6712
Entity
Organization
Contact information
Practice address
2305 N GATEWAY AVE UNIT 5, HARRIMAN, TN 37748-8682
(865) 590-7084
(865) 591-7143
Mailing address
1110 SHAWNEE RD, LIMA, OH 45805-3529
(419) 221-6720
(419) 222-0507
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
04/20/2018
Last updated
04/20/2018
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