Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | OT5921 | OH |
NPI | 1093733297 |
---|---|
Provider Name | Jessica Anne Muchmore |
First Address | Dayton, OH 45420-1143 |
Second Address | Dayton, OH 45420-1143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 08/07/2007 |