Provider Demographics
NPI:1548660608
Name:SOLLARS, BRADLEY ROTROFF (PTA)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:ROTROFF
Last Name:SOLLARS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-1348
Mailing Address - Country:US
Mailing Address - Phone:740-505-4303
Mailing Address - Fax:
Practice Address - Street 1:1151 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-2827
Practice Address - Country:US
Practice Address - Phone:614-231-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA.07710174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist