Provider Demographics
NPI:1154438174
Name:CAMBRIDGE PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:CAMBRIDGE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROCCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-439-7177
Mailing Address - Street 1:216 HIGHLAND AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-2558
Mailing Address - Country:US
Mailing Address - Phone:740-439-7177
Mailing Address - Fax:740-432-1053
Practice Address - Street 1:216 HIGHLAND AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-2558
Practice Address - Country:US
Practice Address - Phone:740-439-7177
Practice Address - Fax:740-432-1053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 007146225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2369360Medicaid
OH2369360Medicaid