MEDICARE: MR. DARRIN PAUL FURMAN 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	261QP2000X	Physical Therapy Clinic/Center	PTA.03669	OH

General Provider Information

NPI Number	:	1598913352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DARRIN PAUL FURMAN PTA

Provider Business Mailing Address
First Line	:	2141 W PROSPECT RD
Second Line	:
City	:	ASHTABULA
State	:	OH
Zip	:	44004-6439
Country	:	US
Telephone Number	:	440-998-7507
Fax Number	:	440-998-6222

Provider Business Practice Location Address
First Line	:	2141 W PROSPECT RD
Second Line	:
City	:	ASHTABULA
State	:	OH
Zip	:	44004-6439
Country	:	US
Telephone Number	:	440-998-7507
Fax Number	:	440-998-6222

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

Provider Enumeration Date	:	09/05/2008
Last Update Date	:	09/05/2008

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