Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT018179 | OH |
NPI | 1184290009 |
---|---|
Provider Name | Beth Wittry |
First Address | Columbus, OH 43215-3699 |
Second Address | Saint Paul, MN 55102-2344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2021 |
Last Update Date | 01/06/2021 |