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NPI Code Detail

MEDICARE: KAYLA DITTEMER

MEDICARE:   KAYLA  DITTEMER
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
1225700000XMassage Therapist33.018598OH

General Provider Information

NPI Number : 1326617424
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA DITTEMER
Provider Business Mailing Address
First Line : 3567 VENTURA BLVD
Second Line :
City : GROVE CITY
State : OH
Zip : 43123-3426
Country : US
Telephone Number : 614-260-9383
Fax Number :
Provider Business Practice Location Address
First Line : 3567 VENTURA BLVD
Second Line :
City : GROVE CITY
State : OH
Zip : 43123-3426
Country : US
Telephone Number : 614-260-9383
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2021
Last Update Date : 06/22/2021

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Directions to “ KAYLA DITTEMER ” Practice Location

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