Provider Demographics
NPI:1386875623
Name:PHYSICAL THERAPY CONSULTIVE SERVICES
Entity type:Organization
Organization Name:PHYSICAL THERAPY CONSULTIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:614-459-2200
Mailing Address - Street 1:2939 KENNY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2406
Mailing Address - Country:US
Mailing Address - Phone:614-459-2200
Mailing Address - Fax:
Practice Address - Street 1:2939 KENNY RD
Practice Address - Street 2:SUITE195
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2406
Practice Address - Country:US
Practice Address - Phone:614-459-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-01008225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty