Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 015186 | OH |
NPI | 1003207366 |
---|---|
Provider Name | Kawsar Choufani |
First Address | North Jackson, OH 44451-9665 |
Second Address | North Jackson, OH 44451-9665 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2015 |
Last Update Date | 09/02/2015 |