Marjuci Bukovac
Individual provider Active NPI Physical Therapy Assistant · Amherst, OH
NPI 1417708124 · NPPES record last updated Mar 29, 2024
Key facts
- NPI
- 1417708124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- PTA012870 (OH)
- Practice address
- 175 N Lake St
Amherst, OH 44001-1332 - Phone
- (440) 988-4415
- NPI assigned
- Mar 29, 2024
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA012870 | OH | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA012870 | OH | Yes |
Addresses
Primary practice location
175 N Lake St
Amherst, OH 44001-1332
Mailing address
720 S Lake St
South Amherst, OH 44001-3014
Phone (440) 381-9291
Other providers in Amherst, OH
- Christine Marie Brown
- Heather Ann Bruderer
- Elizabeth A Bruot
- Ashley Victoria Bruzzese
- Addison Marie Buckholz
- Anastasia Dawn Burkes
- Shane Burnsworth
- Donna Burton
- Jennifer A Calabrese
- Caleb Mental Health LLC
All providers in Amherst, OH · Physical Therapy Assistant in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.