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NPI Code Detail

MEDICARE: MRS. JERI R STRAUB PTA

MEDICARE:  MRS. JERI R STRAUB  PTA
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 AssistantPTA3454OH

General Provider Information

NPI Number : 1164693123
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JERI R STRAUB PTA
Provider Business Mailing Address
First Line : 167 N BUCKEYE ST
Second Line :
City : BELLEVUE
State : OH
Zip : 44811-1433
Country : US
Telephone Number : 419-483-2367
Fax Number :
Provider Business Practice Location Address
First Line : 1069 US HIGHWAY 224
Second Line :
City : NOVA
State : OH
Zip : 44859-9770
Country : US
Telephone Number : 419-652-2219
Fax Number : 419-652-2219
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2008
Last Update Date : 03/18/2008

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Directions to “ MRS. JERI R STRAUB PTA” Practice Location

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