Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 08695 | OH |
N | 226300000X | Kinesiotherapist | 1163 |
NPI | 1952476509 |
---|---|
Provider Name | Joel Jay Cousino |
First Address | Toledo, OH 43612-2205 |
Second Address | Toledo, OH 43617-1094 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 30/09/2013 |