Organization
SPARTAN REHABILITATION, LLC
Active
Other names
Spartan Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOMINIC KOULIANOS P.T. (PHYSICAL THERAPIST)
(330) 758-5533
Entity
Organization
Contact information
Practice address
6431 MAHONING AVE, 2, YOUNGSTOWN, OH 44515-2039
(330) 651-6824
(330) 609-5553
Mailing address
6431 MAHONING AVE, 2, YOUNGSTOWN, OH 44515-2039
(330) 651-6824
(330) 609-5553
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
PT8632
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2198643
—
OH
Enumeration date
01/30/2013
Last updated
08/01/2014
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