Healthcare Provider Details

I. General information

NPI: 1770936981
Provider Name (Legal Business Name): MARY FRANCES ELDER LMT,RMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2016
Last Update Date: 07/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28442 E RIVER RD STE 204205
PERRYSBURG OH
43551-2795
US

IV. Provider business mailing address

515 SOUTH AVE
TOLEDO OH
43609-3333
US

V. Phone/Fax

Practice location:
  • Phone: 419-984-5908
  • Fax: 419-872-3258
Mailing address:
  • Phone: 419-984-5908
  • Fax: 419-872-3258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.023038
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number33.023038
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: