Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT013297 | OH |
NPI | 1376075234 |
---|---|
Provider Name | Jennifer Williams |
First Address | Beachwood, OH 44122-1191 |
Second Address | Beachwood, OH 44122-1191 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2017 |
Last Update Date | 30/03/2017 |