Provider Demographics
NPI:1548652191
Name:SPINE FIRST PHYSICAL THERAPY
Entity type:Organization
Organization Name:SPINE FIRST PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:COREY
Authorized Official - Middle Name:B
Authorized Official - Last Name:URBANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:614-406-4622
Mailing Address - Street 1:3322 WINDY FOREST LN
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7382
Mailing Address - Country:US
Mailing Address - Phone:614-406-4622
Mailing Address - Fax:
Practice Address - Street 1:7720 RIVERS EDGE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1361
Practice Address - Country:US
Practice Address - Phone:614-406-4622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH009687261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy