SPORTS AND SPINE PHYSICAL THERAPY INC; NPI #1619923026

Contact Information

SPORTS AND SPINE PHYSICAL THERAPY INC

3365 RICHMOND RD STE 110
BEACHWOOD, OH 44122-4171

Phone: 216-593-7070
Fax: 216-593-7074
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rehabilitation	261QR0400X	B4[14]	Rehabilitation Agency

Indicates primary specialty

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NPI Profile & details for SPORTS AND SPINE PHYSICAL THERAPY INC

NPI Number 1619923026

LBN Legal business name SPORTS AND SPINE PHYSICAL THERAPY INC

Authorized official TIFFANY WASSON - (REGIONAL ADMINISTRATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/26/2006

Last updated 05/06/2019 - About 7 years ago

Identifiers

OH	Medicaid	2452199
	Other	DD3410	RAILROAD MEDICARE
OH	Other	000000314395	OH BLUE CROSS/ANTHEM

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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