Provider Demographics
NPI:1104922624
Name:GRAF, DANA EILEEN (PT)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:EILEEN
Last Name:GRAF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:DANA
Other - Middle Name:EILEEN
Other - Last Name:RIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3812 WEYMOUTH WOODS DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-7939
Mailing Address - Country:US
Mailing Address - Phone:330-416-6073
Mailing Address - Fax:
Practice Address - Street 1:3812 WEYMOUTH WOODS DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-7939
Practice Address - Country:US
Practice Address - Phone:330-416-6073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH8850PT225100000X
OH88502251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2289910Medicaid
OH2289910Medicaid
OH0892063Medicare PIN