Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225200000X | Physical Therapy Assistant | 00435 | OH |
Y | 225200000X | Physical Therapy Assistant | 2073007 | TX |
NPI | 1023134954 |
---|---|
Provider Name | Mrs. Fern A Sweeney-Martin |
First Address | Maple Heights, OH 44137-0094 |
Second Address | North Randall, OH 44128-4122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 04/12/2013 |