Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT04246 | OH |
NPI | 1043290075 |
---|---|
Provider Name | Mrs. Amy T O'neal |
First Address | Westerville, OH 43081-1397 |
Second Address | Columbus, OH 43212-3129 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 17/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ON4150244 | MEDICARE PTAN (01) | OH |