Laura Michael, PTA

Individual provider Active NPI Skilled Nursing Facility · Payne, OH

NPI 1013389907 · NPPES record last updated Oct 30, 2015

Key facts

NPI
1013389907
Entity type
Individual (NPI type 1)
Primary specialty
Skilled Nursing Facility 314000000X
License
06001999A (IN)
Practice address
5843 State Route 500
Payne, OH 45880-9408
Phone
(260) 385-4234
NPI assigned
Oct 30, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
06001999AINMDSkilled Nursing Facility

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 06001999A IN Yes

Addresses

Primary practice location

5843 State Route 500
Payne, OH 45880-9408

Mailing address

5843 State Route 500
Payne, OH 45880-9408
Phone (260) 385-4234

Other providers in Payne, OH

All providers in Payne, OH · Skilled Nursing Facility in Ohio

Sources for this page

Verify at the official NPI Registry.