Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT7030 | OH |
N | 2251G0304X | Physical Therapist - Geriatrics | PT7030 | OH |
NPI | 1063845493 |
---|---|
Provider Name | Mark D Houser |
First Address | Columbus, OH 43220-5423 |
Second Address | Columbus, OH 43220-5423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2013 |
Last Update Date | 21/08/2013 |