Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT.007426 | OH |
NPI | 1003232877 |
---|---|
Provider Name | Mr. Douglas Newlon |
First Address | Lyndhurst, OH 44124-3817 |
Second Address | Euclid, OH 44119-1078 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2014 |
Last Update Date | 17/03/2014 |