Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics |
NPI | 1316603665 |
---|---|
Provider Name | Mr. Andrew Hover |
First Address | Bedford, OH 44146-2000 |
Second Address | Bedford, OH 44146-2000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2021 |
Last Update Date | 11/11/2021 |