Provider Demographics
NPI:1902086580
Name:NORTH SUMMIT PHYSICAL THERAPY AND ATHLETIC EDGE, INC
Entity Type:Organization
Organization Name:NORTH SUMMIT PHYSICAL THERAPY AND ATHLETIC EDGE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:ALESNIK
Authorized Official - Suffix:
Authorized Official - Credentials:PT, ATC
Authorized Official - Phone:330-771-0860
Mailing Address - Street 1:9945 VAIL DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-4900
Mailing Address - Country:US
Mailing Address - Phone:330-405-3343
Mailing Address - Fax:330-487-1093
Practice Address - Street 1:9945 VAIL DR
Practice Address - Street 2:SUITE 4
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-4900
Practice Address - Country:US
Practice Address - Phone:330-405-3343
Practice Address - Fax:330-487-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-12
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 07828261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy