Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT2776 | OH |
NPI | 1033518238 |
---|---|
Provider Name | Michael Zimmerman |
First Address | Wadsworth, OH 44281-8597 |
Second Address | Wadsworth, OH 44281-8597 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2014 |
Last Update Date | 14/08/2014 |