Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | REGISTRY NO. 1547 | OH |
NPI | 1457570905 |
---|---|
Provider Name | Mrs. Lisa Ann Urban |
First Address | Sylvania, OH 43560-2854 |
Second Address | Oregon, OH 43616-3205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 08/07/2007 |