Healthcare Provider Details

I. General information

NPI: 1821350737
Provider Name (Legal Business Name): ANN BARTLETT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2012
Last Update Date: 06/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 NORMANDY DR
PAINESVILLE OH
44077-1600
US

IV. Provider business mailing address

7923 MUNSON RD STE 6
MENTOR ON THE LAKE OH
44060-3742
US

V. Phone/Fax

Practice location:
  • Phone: 440-639-8800
  • Fax:
Mailing address:
  • Phone: 440-209-1836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3835
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: