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General NPI Number Information
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NPI Number | 1205854346
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Entity Type | Individual
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Provider Name | ANN MARIE VETTER PA
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 04/07/2022
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Provider Practice Location Address
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Address Line | 970 E WASHINGTON ST
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City | MEDINA
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State | OH
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Zip | 44256-3332
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Country | US
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Telephone | 330-721-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 2465 FOREST DR
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City | HINCKLEY
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State | OH
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Zip | 44233-9518
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Country | US
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Telephone | 716-572-9558
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 50.003180
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License Number State | OH
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