Park Rehab, Inc.
Organization Active NPI Geriatric Physical Therapist · Etna, OH
NPI 1790981033 · NPPES record last updated Dec 12, 2022
Key facts
- NPI
- 1790981033
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Geriatric Physical Therapist 2251G0304X
- License
- 004514 (OH)
- Legal business name
- PARK REHAB, INC.
- Practice address
- 14176 National Rd SW
Etna, OH 43068-3363 - Phone
- (740) 927-6782
- NPI assigned
- Jun 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Todd T Park, M.S., P.T.
- Title
- Pres
- Phone
- (740) 927-6782
Practitioners 19
-
Jamie E Crites, SLP
-
Laurie R Dynes, OTR/L
-
Julie Ann Mast, P.T.
-
Todd Thomas Park, DPT
-
Sierra Smith, OTR/L, OTD
-
Lindsey Tate, D.P.T.
-
Phillip E Stahr, MSPT
-
Joseph Scott Jemson, PTA
-
James L Wickham, ATC/L
-
Amber Nicole Winnestaffer, PTA 07025
-
Alyson Gates Seibert, PT, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200504001478 | OH | Part B Supplier - Clinic/Group Practice | 6901237155 |
Receives reassigned benefits from 7 practitioners Practice locations: Etna, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Physical Therapist |
2251G0304X | 004514 | OH | Yes |
Addresses
Primary practice location
14176 National Rd SW
Etna, OH 43068-3363
Mailing address
14176 National Rd SW
Etna, OH 43068-3363
Phone (740) 927-6782
Other providers in Etna, OH
- Music Makers LLC
- Jodi C Neff
- NK Fitness and Nutrition, LLC
- Nijya Noble
- Linda D Osborne
- Todd Thomas Park
- Pinnacle Chiropractic and Physical Therapy
- Quad/Med, LLC
- Douglas M Reckner
- Hannah Marie Rogers
All providers in Etna, OH · Geriatric 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 Dec 12, 2022. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.