Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT-4414 | OH |
NPI | 1255583472 |
---|---|
Provider Name | Tonya King |
First Address | Springfield, OH 45503-2445 |
Second Address | Springfield, OH 45503-2445 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 12/06/2020 |