Provider Demographics
NPI:1992991574
Name:EAST POINT REHABILITATION LLC
Entity type:Organization
Organization Name:EAST POINT REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:WALENDZAK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:419-693-0676
Mailing Address - Street 1:2815 DUSTIN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3495
Mailing Address - Country:US
Mailing Address - Phone:419-693-0676
Mailing Address - Fax:419-693-0807
Practice Address - Street 1:2815 DUSTIN RD
Practice Address - Street 2:SUITE B
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3497
Practice Address - Country:US
Practice Address - Phone:419-693-0676
Practice Address - Fax:419-693-0807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty