Basic Information
| Provider Information | |||||||||
| NPI: | 1528046992 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORION PHYSICAL THERAPY SPECIALISTS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 BAKER BLVD STE 1 | ||||||||
| Address2: | |||||||||
| City: | FAIRLAWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443333633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308651600 | ||||||||
| FaxNumber: | 9376606358 | ||||||||
| Practice Location | |||||||||
| Address1: | 1222 S PATTERSON BLVD | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454022684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372273174 | ||||||||
| FaxNumber: | 9372273325 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2006 | ||||||||
| LastUpdateDate: | 05/16/2012 | ||||||||
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| AuthorizedOfficialLastName: | ANLOAGUE | ||||||||
| AuthorizedOfficialFirstName: | PHIL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9372273174 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.