Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | PT012967 | OH |
NPI | 1467808063 |
---|---|
Provider Name | Ryan Monti |
First Address | Cuyahoga Falls, OH 44223-2449 |
Second Address | North Canton, OH 44720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2016 |
Last Update Date | 03/07/2018 |