Healthcare Provider Details

I. General information

NPI: 1821236076
Provider Name (Legal Business Name): JOANNA BARBARA SHATLAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 OAK ST.
CINCINNATI OH
45219-2504
US

IV. Provider business mailing address

411 OAK ST STERLING MEDICAL ASSOCIATES ATTN: CREDENTIALS
CINCINNATI OH
45219-2504
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-1800
  • Fax:
Mailing address:
  • Phone: 513-984-1800
  • Fax: 513-984-4909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number003011
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: