Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 006256 | OH |
NPI | 1336566108 |
---|---|
Provider Name | Ms. Maria Mepham |
First Address | Lakewood, OH 44107-4316 |
Second Address | Lakewood, OH 44107-4316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2014 |
Last Update Date | 18/03/2014 |