Southern Ohio Sports Medicine and Physical Therapy

NPI #1700188463 in Peebles, Ohio

Provider Information

NPI Number: 1700188463
Entity Type: Organization
Organization Name: Southern Ohio Sports Medicine and Physical Therapy
Primary Specialty: Specialist
Enumeration Date: Nov 30, 2010
Last Updated: Nov 30, 2010

Practice Location

Address: 118 RARDEN RD
City: Peebles
State: Ohio
ZIP Code: 45660-1049
Phone: (937) 587-9422

Authorized Official

Name: MRS. MELISSA MAE WADDELL, PT
Title: PHYSICAL THERAPIST
Phone: (937) 587-9422

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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