Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT.015086 | OH |
NPI | 1003211525 |
---|---|
Provider Name | Heather Witt |
First Address | Columbus, OH 43213-1576 |
Second Address | Columbus, OH 43213-1576 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2014 |
Last Update Date | 27/10/2014 |