Olusegun Agaja
Individual provider Active NPI Physical Therapist · Gallipolis, OH
NPI 1013497635 · NPPES record last updated Aug 14, 2018
Key facts
- NPI
- 1013497635
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT017380 (OH)
- Practice address
- 170 Pinecrest Dr
Gallipolis, OH 45631-1347 - Phone
- (740) 446-7112
- NPI assigned
- Aug 14, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260627000309 | MI | Order and Referring Only - Psychiatry |
1557695491 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT017380 | OH | Yes |
Addresses
Primary practice location
170 Pinecrest Dr
Gallipolis, OH 45631-1347
Mailing address
4242 Bushnell Rd
University Heights, OH 44118-3310
Phone (216) 554-0513
Other providers in Gallipolis, OH
- Linda L Adams
- Julie Lynn Addis
- Jennifer Adkins
- Keirsten Adkins
- Advanced Hearing Centers, Inc.
- Sidra Ahmed
- Neha Ahuja
- Sarah Christine Allen O'Brien
- Adam Robert Martin Alley
- Zahran M. Emad Alras
All providers in Gallipolis, OH · Physical Therapist in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.