Provider Demographics
NPI:1154723732
Name:POWER AHEAD PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:POWER AHEAD PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-972-4264
Mailing Address - Street 1:PO BOX 50
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-0050
Mailing Address - Country:US
Mailing Address - Phone:740-966-5444
Mailing Address - Fax:740-966-5442
Practice Address - Street 1:333 W COSHOCTON ST
Practice Address - Street 2:STE C
Practice Address - City:JOHNSTOWN
Practice Address - State:OH
Practice Address - Zip Code:43031-1112
Practice Address - Country:US
Practice Address - Phone:740-966-5444
Practice Address - Fax:740-966-5442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty