Provider Demographics
NPI:1548438500
Name:HEMENWAY, ERIK W (PTA, ATC)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:W
Last Name:HEMENWAY
Suffix:
Gender:M
Credentials:PTA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 N HAMILTON RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1757
Mailing Address - Country:US
Mailing Address - Phone:614-293-7600
Mailing Address - Fax:614-293-7540
Practice Address - Street 1:2050 KENNY RD
Practice Address - Street 2:SUITE 3100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3502
Practice Address - Country:US
Practice Address - Phone:614-293-3600
Practice Address - Fax:614-293-4399
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA.07472225200000X
IN06003631A225200000X
IN36001444A2255A2300X
OHAT.0033222255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer