| Organization Name: | ANTONINE THERAPY CENTER |
| NPI Number: | 1528451432 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARIE MADELEINE ISKANDAR (PRESIDENT) |
| Mailing Address: | 2675 N Lipkey Rd North Jackson |
| State: | OH US |
| Postal Code: | 444519665 |
| Phone Number: | 3305389822 |
| Fax Number: | 3305389820 |
| NPI Enumeration Date: | 03/17/2015 |
| NPI Last Update Date: | 03/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |