Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant |
NPI | 1003386319 |
---|---|
Provider Name | Melissa Owens |
First Address | Cincinnati, OH 45247-7441 |
Second Address | Cincinnati, OH 45236-3506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2018 |
Last Update Date | 29/11/2018 |