Healthcare Provider Details

I. General information

NPI: 1750910642
Provider Name (Legal Business Name): ERIN TAYLOR MIZER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 03/15/2021
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5334 MEADOW LANE CT
SHEFFIELD VILLAGE OH
44035-1469
US

IV. Provider business mailing address

37382 YELLOW BEAK LN
NORTH RIDGEVILLE OH
44039-5805
US

V. Phone/Fax

Practice location:
  • Phone: 440-695-5875
  • Fax:
Mailing address:
  • Phone: 440-781-9822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT017502
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: