Mark Daniel Dewitt
Physical Therapy Assistant in Rockford, OH. Individual provider (NPI-1).
NPI number1457085508
StatusActive
Last updated in NPPESJul 14, 2022
Details
- NPI
- 1457085508
- Entity type
- Individual (NPI-1)
- Name
- Mark Daniel Dewitt
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 14, 2022
- Certification date
- Jul 14, 2022
- Last updated
- Jul 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | – | – | Yes |
Practice location
201 Buckeye StRockford, OH 45882-9266
Phone 419-363-2193
Mailing address
Po Box 464Delphos, OH 45833-0464
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