Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1866 | OH |
NPI | 1811485261 |
---|---|
Provider Name | Miss Amber Marie Edmond |
First Address | Wooster, OH 44691-9648 |
Second Address | Dayton, OH 45428-9000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2018 |
Last Update Date | 01/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1866 | COUNCIL ON PROFESSIONAL STANDARDS FOR KINESIOTHERAPY (01) | OH |
236845 | YOGA ALLIANCE (01) | OH |