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NPI Code Detail

MEDICARE: MISS TORI MICHELLE EDDINGTON PTA

MEDICARE: MISS TORI MICHELLE EDDINGTON PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantPTA012739OH

General Provider Information

NPI Number : 1871206607
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TORI MICHELLE EDDINGTON PTA
Provider Business Mailing Address
First Line : 1809 JOHN GLENN RD
Second Line :
City : DAYTON
State : OH
Zip : 45420-2412
Country : US
Telephone Number : 937-271-7693
Fax Number :
Provider Business Practice Location Address
First Line : 5070 LAMME RD
Second Line :
City : MORAINE
State : OH
Zip : 45439-3266
Country : US
Telephone Number : 937-293-7703
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2022
Last Update Date : 12/26/2022

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Directions to “ MISS TORI MICHELLE EDDINGTON PTA” Practice Location

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