Provider Demographics
NPI:1124339650
Name:FERREL, JOANNA MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:MARIE
Last Name:FERREL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:JOANNA
Other - Middle Name:MARIE
Other - Last Name:GENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2458 WYOMING ST
Mailing Address - Street 2:APT A
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45410-2941
Mailing Address - Country:US
Mailing Address - Phone:567-259-9760
Mailing Address - Fax:
Practice Address - Street 1:8051 WASHINGTON VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-1885
Practice Address - Country:US
Practice Address - Phone:937-291-3160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012792225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist