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General NPI Number Information
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NPI Number | 1164693123
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Entity Type | Individual
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Provider Name | JERI R STRAUB PTA
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Gender | Female
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 1069 US HIGHWAY 224
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City | NOVA
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State | OH
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Zip | 44859-9770
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Country | US
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Telephone | 419-652-2219
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Fax | 419-652-2219
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Provider Business Mailing Address
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Address Line | 167 N BUCKEYE ST
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City | BELLEVUE
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State | OH
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Zip | 44811-1433
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Country | US
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Telephone | 419-483-2367
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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 | PTA3454
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License Number State | OH
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