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General NPI Number Information
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NPI Number | 1376100552
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Entity Type | Organization
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Legal Business Name | OHIO UNIVERSITY
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 1 OHIO UNIVERSITY FL 5
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City | ATHENS
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State | OH
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Zip | 45701-2942
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Country | US
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Telephone | 740-593-1173
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Fax |
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Provider Business Mailing Address
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Address Line | 5050 SPRING VALLEY RD
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City | DALLAS
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State | TX
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Zip | 75244-3995
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | AMY DEAN
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Credential |
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Telephone | 740-593-1171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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