Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT.006500 | OH |
NPI | 1053710731 |
---|---|
Provider Name | Timothy Tomcik |
First Address | Cuyahoga Falls, OH 44223-2516 |
Second Address | Cuyahoga Falls, OH 44223-2516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2014 |
Last Update Date | 19/08/2014 |