Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 001906 | OH |
NPI | 1285841999 |
---|---|
Provider Name | Beth Phillips |
First Address | Canton, OH 44705-4431 |
Second Address | Canton, OH 44708-2614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |