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General NPI Number Information
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NPI Number | 1780387274
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Entity Type | Individual
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Provider Name | ANNEMARIE DANIELLE MASON PTA
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Gender | Female
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Dates
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Enumeration Date | 03/23/2023
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 1198 SMILEY AVE STE F
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City | CINCINNATI
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State | OH
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Zip | 45240-1866
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Country | US
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Telephone | 513-671-6362
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Fax |
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Provider Business Mailing Address
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Address Line | 140 BENT TREE DR APT 1B
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City | FAIRFIELD
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State | OH
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Zip | 45014-6735
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Country | US
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Telephone | 740-816-7799
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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 | PTA11483
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License Number State | OH
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