Provider Demographics
NPI:1972818037
Name:PT WORKS, LLC
Entity type:Organization
Organization Name:PT WORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPTA, PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-559-9179
Mailing Address - Street 1:4307 LANTERMAN RD
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-1434
Mailing Address - Country:US
Mailing Address - Phone:330-559-9179
Mailing Address - Fax:330-965-6476
Practice Address - Street 1:4307 LANTERMAN RD
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-1434
Practice Address - Country:US
Practice Address - Phone:330-559-9179
Practice Address - Fax:330-965-6476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH9056225100000X
OH04983225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty