Provider Demographics
NPI:1356525919
Name:OHIO PHYSICAL MEDICINE & REHABILITATION, INC.
Entity type:Organization
Organization Name:OHIO PHYSICAL MEDICINE & REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:H
Authorized Official - Last Name:PEARLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-681-9905
Mailing Address - Street 1:2405 N COLUMBUS ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8185
Mailing Address - Country:US
Mailing Address - Phone:740-681-9905
Mailing Address - Fax:740-681-9726
Practice Address - Street 1:2405 N COLUMBUS ST
Practice Address - Street 2:SUITE 210
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8185
Practice Address - Country:US
Practice Address - Phone:740-681-9905
Practice Address - Fax:740-681-9726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2111413Medicaid
OH=========00OtherBWC
OH2111413Medicaid