| Organization Name: | BUCKEYE PHYSICAL MEDICINE AND REHAB - GAHANNA |
| NPI Number: | 1578900783 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KARLA TALLEDO (DIRECTOR OF OPERATIONS) |
| Mailing Address: | 1358a Cherry Bottom Rd Gahanna |
| State: | OH US |
| Postal Code: | 432306771 |
| Phone Number: | 6144712225 |
| Fax Number: | 6144714260 |
| NPI Enumeration Date: | 05/29/2013 |
| NPI Last Update Date: | 07/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |