Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT-005405 | OH |
NPI | 1215184122 |
---|---|
Provider Name | Lisa Kohler |
First Address | Mason, OH 45040-5657 |
Second Address | Mason, OH 45040-5657 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2008 |
Last Update Date | 21/08/2008 |