Organization · NPI-2
3 Phase Performance Therapy And Sports
Occupational Therapist · Cecil, OH
NPI number1619862463
StatusActive
Last updated in NPPESJun 11, 2025
Details
- NPI
- 1619862463
- Entity type
- Organization (NPI-2)
- Legal business name
- 3 Phase Performance Therapy And Sports
- Organization subpart
- No
- Enumeration date
- Jun 11, 2025
- Certification date
- Jun 11, 2025
- Last updated
- Jun 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225X00000X | Occupational Therapist | – | – | Yes |
Practice location
11154 Road 230Cecil, OH 45821-9309
Phone 419-438-5026 · Fax 419-438-5026
Mailing address
11154 Road 230Cecil, OH 45821-9309
Phone 419-438-5026 · Fax 419-438-5026
Authorized official
Seth M Bidlack
Owner
4194385024
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