Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA. 09804 | OH |
NPI | 1003214693 |
---|---|
Provider Name | Breanna Jones |
First Address | Findlay, OH 45840-4163 |
Second Address | Louisville, KY 40222-5158 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2014 |
Last Update Date | 12/12/2014 |