Doctor Name: | MRS. MEGAN MARIE BRODWOLF |
NPI Number: | 1700021086 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MPT |
License Number: | PT.012139 |
Business Practice Address: | 333 North Street Ste 102 Delphos, OH - 458331070 |
Business Phone Number: | 4196920095 |
Business Fax Number: | 4196920097 |
Mailing Address: | 1880 N. Perry St, Ste 100 OTTAWA |
State: | OH |
Postal Code: | 458751164 |
Phone Number: | 4195239003 |
Fax Number: | 4195239143 |
NPI Enumeration Date: | 12/15/2008 |
NPI Last Update Date: | 01/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | PT.012139 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |