Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 013310 | OH |
N | 2251G0304X | Physical Therapist - Geriatrics | 013310 | OH |
NPI | 1265861017 |
---|---|
Provider Name | Alana Bedal |
First Address | Waterville, OH 43566-1516 |
Second Address | Waterville, OH 43566-1516 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2013 |
Last Update Date | 02/11/2013 |