Provider Demographics
NPI:1932389178
Name:RIMKUS, GREGORY ANTHONY (PT)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:ANTHONY
Last Name:RIMKUS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 MAE ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-9392
Mailing Address - Country:US
Mailing Address - Phone:740-603-2791
Mailing Address - Fax:740-385-0888
Practice Address - Street 1:288 MAE ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:OH
Practice Address - Zip Code:43138-9392
Practice Address - Country:US
Practice Address - Phone:740-603-2791
Practice Address - Fax:740-385-0888
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-6113225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4065741Medicare PIN