=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326256140
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EVA MARGARETA HUEY P.T.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2007
-----------------------------------------------------
Last Update Date | 09/05/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 WYOMING ST
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45409-2722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-208-6090
-----------------------------------------------------
Fax | 937-208-4868
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 420 HATHAWAY RD
-----------------------------------------------------
City | DAYTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45419-3916
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-298-9796
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 2975
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------