Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 35-07-2965-T | OH |
Y | 213ES0000X | Sports Medicine | 35-07-2965-T | OH |
NPI | 1336201334 |
---|---|
Provider Name | Kimberly Ann Togliatti-Trickett |
First Address | Parma, OH 44129-6746 |
Second Address | Independence, OH 44131-4848 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 30/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2361260 | (05) | OH |
H49465 | (02) | OH |