Facts
- Status
- A
- Credential
- OTR/L
- Type
- Individual
- Enumeration date
- 2008-03-19
- Last updated
- 2008-03-21
Specialties
Licenses
- License OH
- OT002770
Location
- Practice location
- 1069 US HIGHWAY 224
- City
- NOVA OH
- Postal code
- 448599770
- Phone
- 419-652-2219
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
Search this city from the state hub for other records in the public registry.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.