Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 003 | OH |
NPI | 1003865379 |
---|---|
Provider Name | Colleen Ann Miller |
First Address | Hudson, OH 44236-1447 |
Second Address | Seven Hills, OH 44131-2540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2006 |
Last Update Date | 08/07/2007 |