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General NPI Number Information
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NPI Number | 1053292995
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Entity Type | Individual
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Provider Name | EMILY NICOLE RADCLIFF PTA
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Gender | Female
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 2550 MELMORE ST
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City | TIFFIN
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State | OH
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Zip | 44883
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Country | US
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Telephone | 800-447-8331
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Fax |
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Provider Business Mailing Address
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Address Line | 2198 HERON LN
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City | MARION
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State | OH
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Zip | 43302-8279
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Country | US
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Telephone | 419-560-0313
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA014052
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License Number State | OH
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