MEDICARE: MS. ERIN L KRONBERG 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
1	225200000X	Physical Therapy Assistant	05730	OH

General Provider Information

NPI Number	:	1164839833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ERIN L KRONBERG LPTA

Provider Business Mailing Address
First Line	:	6855 SPRING VALLEY DR STE 155
Second Line	:
City	:	HOLLAND
State	:	OH
Zip	:	43528-9374
Country	:	US
Telephone Number	:	419-291-8900
Fax Number	:	419-866-1316

Provider Business Practice Location Address
First Line	:	6855 SPRING VALLEY DR STE 155
Second Line	:
City	:	HOLLAND
State	:	OH
Zip	:	43528-9374
Country	:	US
Telephone Number	:	419-291-8900
Fax Number	:	419-866-1316

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2014
Last Update Date	:	07/15/2014

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