| NPI | 1285724039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LEE SHINE KOOP Member Of LLC 419-471-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH 009627) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2022-11-30 |