Healthcare Provider Details

I. General information

NPI: 1619023884
Provider Name (Legal Business Name): LINDA TERESA HOTZ LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4210 TELEGRAPH LN
VERMILION OH
44089-3748
US

IV. Provider business mailing address

2864 WHISPERING SHORES DR
VERMILION OH
44089-2588
US

V. Phone/Fax

Practice location:
  • Phone: 440-967-1800
  • Fax: 440-976-0122
Mailing address:
  • Phone: 440-963-0304
  • Fax: 440-963-2050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2622
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: