MEDICARE: JULIE ANKNEY 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
1	225200000X	Physical Therapy Assistant	PTA.08916	OH

General Provider Information

NPI Number	:	1588084255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANKNEY PTA

Provider Business Mailing Address
First Line	:	23263 GRIST MILL CT
Second Line	:
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-3220
Country	:	US
Telephone Number	:	865-622-1607
Fax Number	:

Provider Business Practice Location Address
First Line	:	4229 PEARL RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-4218
Country	:	US
Telephone Number	:	216-205-4000
Fax Number	:

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

Provider Enumeration Date	:	04/22/2014
Last Update Date	:	04/22/2014

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