Healthcare Provider Details

I. General information

NPI: 1245458793
Provider Name (Legal Business Name): CATHY LOUISE FROMBAUGH LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1069 US HIGHWAY 224
NOVA OH
44859-9770
US

IV. Provider business mailing address

49515 BURSLEY RD
WELLINGTON OH
44090-9282
US

V. Phone/Fax

Practice location:
  • Phone: 419-652-2219
  • Fax:
Mailing address:
  • Phone: 440-647-5771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA 05522
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: