Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 015528 | OH |
NPI | 1063880334 |
---|---|
Provider Name | Christin Close |
First Address | West Chester, OH 45069 |
Second Address | West Chester, OH 45069 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2015 |
Last Update Date | 03/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2187155 | (05) | OH |