Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 35.140019 | OH |
NPI | 1033564521 |
---|---|
Provider Name | Vanessa Wanjeri |
First Address | Portsmouth, OH 45662-2681 |
Second Address | Portsmouth, OH 45662-2640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2016 |
Last Update Date | 16/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0409336 | (05) | OH |