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General NPI Number Information
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NPI Number | 1609992544
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Entity Type | Individual
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Provider Name | MARY E FALLON PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 720 JARVIS RD.
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City | AKRON
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State | OH
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Zip | 44319-2538
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Country | US
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Telephone | 330-645-0200
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Fax | 330-645-2110
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Provider Business Mailing Address
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Address Line | 522 HARTMAN ST. S. E.AVE.
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City | N. CANTON
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State | OH
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Zip | 04472
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Country | US
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Telephone | 330-699-0960
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Fax | 330-699-0960
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 00647
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License Number State | OH
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