Penny Hines, OTR/L
Individual provider Active NPI Contractor · Medway, OH
NPI 1801295100 · NPPES record last updated Aug 22, 2014
Key facts
- NPI
- 1801295100
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- OH OT-2274 (OH)
- Practice address
- 11755 Gerlaugh Rd
Medway, OH 45341-9407 - Phone
- (937) 205-6642
- NPI assigned
- Aug 22, 2014
- 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 |
|---|---|---|---|
| OH OT-2274 | OH | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | OH OT-2274 | OH | Yes |
Addresses
Primary practice location
11755 Gerlaugh Rd
Medway, OH 45341-9407
Mailing address
11755 Gerlaugh Rd
Medway, OH 45341-9407
Phone (937) 205-6642
Other providers in Medway, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2014. 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.