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NPI 1124244231

NPI 1124244231 : WENDY REE CONTI PTA : TIFFIN, OH

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General NPI Number Information
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    NPI Number           |    1124244231
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    Entity Type          |    Individual 
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    Provider Name        |    WENDY REE CONTI PTA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/17/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    825 TOWNSHIP ROAD 1172 
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    City                 |    TIFFIN
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    State                |    OH
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    Zip                  |    44883-8807
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    Country              |    US
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    Telephone            |    419-447-6090
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    825 RANCHWOOD DR. 
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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            |    419-447-6090
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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       |    04565
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    License Number State |    OH
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