Provider Demographics
NPI: | 1326028069 |
---|---|
Name: | RICE, WILLIAM LAWRENCE III (PT) |
Entity type: | Individual |
Prefix: | MR |
First Name: | WILLIAM |
Middle Name: | LAWRENCE |
Last Name: | RICE |
Suffix: | III |
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: | 700 CHILDRENS DR STE C |
Mailing Address - Street 2: | |
Mailing Address - City: | COLUMBUS |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 43205-2639 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 614-722-2000 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 150 W MAIN ST |
Practice Address - Street 2: | |
Practice Address - City: | NEW ALBANY |
Practice Address - State: | OH |
Practice Address - Zip Code: | 43054-9229 |
Practice Address - Country: | US |
Practice Address - Phone: | 614-685-9425 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-01-19 |
Last Update Date: | 2025-04-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | PT10771 | 2251P0200X, 225100000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OH | 0144742 | Medicaid |