Lisseth Corina Bediako PTA

NPI 1780093427 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1780093427
Gender Female
Enumeration Date 08/06/2014
Last Updated 08/06/2014
Entity Type Individual
Active Over 2 years ago
Practice Location
303 N HURSTBOURNE PKWY
SUITE 200
LOUISVILLE KY, 40222-5185, US
Phone (502) 412-5847
Fax
Business Location
15 ELM ST
APT 1
SOMERVILLE MA, 02143-2230, US
Phone (847) 322-5898
Fax
Toxanomy
Taxonomy Code 225200000X
License State Massachusetts
License Number 8901
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According to our database, Lisseth Corina Bediako PTA NPI is 1780093427, taxonomy code is 225200000X and license number is 8901, license state is located at Massachusetts. Lisseth Corina Bediako PTA physically located at 303 N Hurstbourne Pkwy, Louisville KY, 40222-5185. NPI Number Lisseth Corina Bediako PTA has the Individual type.

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1780093427 NPI number is provided on an as is basis without warranty of any kind. 1780093427 is maintained by the National Plan & Provider Enumeration System. The contents of Lisseth Corina Bediako PTA are for informational purposes only.