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NPI Code Detail

MEDICARE: MRS. FERN A SWEENEY-MARTIN LPTA

MEDICARE: MRS. FERN A SWEENEY-MARTIN LPTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant00435OH
2225200000XPhysical Therapy Assistant2073007TX

General Provider Information

NPI Number : 1023134954
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. FERN A SWEENEY-MARTIN LPTA
Provider Business Mailing Address
First Line : PO BOX 37094
Second Line :
City : MAPLE HEIGHTS
State : OH
Zip : 44137-0094
Country : US
Telephone Number : 216-970-9418
Fax Number : 216-901-0401
Provider Business Practice Location Address
First Line : 20265 EMERY RD
Second Line :
City : NORTH RANDALL
State : OH
Zip : 44128-4122
Country : US
Telephone Number : 216-475-8880
Fax Number : 216-587-4806
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 12/04/2013

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