| NPI | 1962462770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: OH PT-5557) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH 22 030 630) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: OH 22 030 630) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: OH PT -5557) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2019-02-28 |