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General NPI Number Information
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NPI Number | 1356814834
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Entity Type | Individual
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Provider Name | MICHELE SANOR PTA
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Gender | Female
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 451 VALLEY RD
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City | SALEM
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State | OH
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Zip | 44460-9725
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Country | US
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Telephone | 330-537-4621
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Fax |
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Provider Business Mailing Address
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Address Line | 26444 STATE ROUTE 172
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City | EAST ROCHESTER
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State | OH
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Zip | 44625-9734
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Country | US
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Telephone | 330-205-3257
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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 | PTA03938
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License Number State | OH
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