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NPI Code Detail

MEDICARE: MRS. ROSE JILLIAN ENOMATE OTR/L

MEDICARE: MRS. ROSE JILLIAN ENOMATE OTR/L
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
1226300000XKinesiotherapist1695OH

General Provider Information

NPI Number : 1376894295
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROSE JILLIAN ENOMATE OTR/L
Provider Business Mailing Address
First Line : 1237 OAKFIELD DR S
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-1953
Country : US
Telephone Number : 419-290-6717
Fax Number :
Provider Business Practice Location Address
First Line : 1060 EASTWIND DR
Second Line :
City : WESTERVILLE
State : OH
Zip : 43081-3331
Country : US
Telephone Number : 614-212-6766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2012
Last Update Date : 02/06/2018

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Directions to “ MRS. ROSE JILLIAN ENOMATE OTR/L” Practice Location

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