Provider Demographics
NPI:1972194736
Name:SUHAR, JOHN J (PTA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:SUHAR
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8133 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2256
Mailing Address - Country:US
Mailing Address - Phone:330-609-8600
Mailing Address - Fax:330-609-5237
Practice Address - Street 1:8133 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2256
Practice Address - Country:US
Practice Address - Phone:330-609-8600
Practice Address - Fax:330-609-5237
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA004153225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant