Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 014965 | OH |
NPI | 1003225053 |
---|---|
Provider Name | Hannah Lockard |
First Address | Youngstown, OH 44515-4084 |
Second Address | Youngstown, OH 44505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2014 |
Last Update Date | 31/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2577162 | (05) | OH |