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General NPI Number Information
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NPI Number | 1306315544
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Entity Type | Individual
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Provider Name | MARY BETH MOSIER LPTA
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Gender | Female
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Dates
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Enumeration Date | 11/16/2018
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Last Update Date | 11/16/2018
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Provider Practice Location Address
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Address Line | 200 LAUREL LAKE DR
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City | HUDSON
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State | OH
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Zip | 44236-2156
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Country | US
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Telephone | 440-475-3814
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Fax |
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Provider Business Mailing Address
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Address Line | 8017 DARTWORTH DR
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City | PARMA
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State | OH
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Zip | 44129-3931
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Country | US
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Telephone | 440-476-3814
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA2900
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License Number State | OH
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