Provider Demographics
NPI:1700247723
Name:FOCUS PHYSICAL THERAPY AND SPORTS MEDICINE
Entity type:Organization
Organization Name:FOCUS PHYSICAL THERAPY AND SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CODY
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:614-565-5036
Mailing Address - Street 1:1194 COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-6015
Mailing Address - Country:US
Mailing Address - Phone:614-948-3514
Mailing Address - Fax:614-948-3515
Practice Address - Street 1:1194 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-6015
Practice Address - Country:US
Practice Address - Phone:614-948-3514
Practice Address - Fax:614-948-3515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011394261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy