Provider Demographics
NPI:1306315544
Name:MOSIER, MARY BETH (LPTA)
Entity type:Individual
Prefix:MRS
First Name:MARY BETH
Middle Name:
Last Name:MOSIER
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MS
Other - First Name:MARY BETH
Other - Middle Name:
Other - Last Name:SZAFTANSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8017 DARTWORTH DR
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-3931
Mailing Address - Country:US
Mailing Address - Phone:440-476-3814
Mailing Address - Fax:
Practice Address - Street 1:200 LAUREL LAKE DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-2156
Practice Address - Country:US
Practice Address - Phone:440-475-3814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225200000X
OHPTA2900225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant