Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1695 | OH |
NPI | 1376894295 |
---|---|
Provider Name | Mrs. Rose Jillian Enomate |
First Address | Columbus, OH 43229-1953 |
Second Address | Westerville, OH 43081-3331 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2012 |
Last Update Date | 06/02/2018 |