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General NPI Number Information
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NPI Number | 1790181626
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Entity Type | Individual
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Provider Name | NANCY PADDOCK PT
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Gender | Female
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Dates
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Enumeration Date | 11/04/2014
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 6000 YOUNGSTOWN WARREN RD
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City | NILES
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State | OH
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Zip | 44446-4624
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Country | US
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Telephone | 330-505-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 5291 SMITH STEWART RD
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City | GIRARD
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State | OH
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Zip | 44420-1341
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Country | US
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Telephone | 330-509-8094
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 003349
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License Number State | OH
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