Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 10107 | OH |
NPI | 1235348780 |
---|---|
Provider Name | Mr. Anthony Ganim |
First Address | Hilliard, OH 43026-6073 |
Second Address | Columbus, OH 43221-3502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |