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NPI Code Detail

MEDICARE: LAURA M O'LEARY PA

MEDICARE: LAURA M O'LEARY PA
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
1363AM0700XMedical Physician Assistant50001378OH

General Provider Information

NPI Number : 1629075171
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA M O'LEARY PA
Provider Business Mailing Address
First Line : 2142 N COVE BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43606-3895
Country : US
Telephone Number : 419-291-5318
Fax Number : 419-291-6430
Provider Business Practice Location Address
First Line : 2142 N COVE BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43606-3895
Country : US
Telephone Number : 419-291-5318
Fax Number : 419-291-6430
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 11/03/2023

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Directions to “ LAURA M O'LEARY PA” Practice Location

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