Provider Demographics
NPI:1003471186
Name:MOTZ, ABIGAIL J (PRS)
Entity Type:Individual
Prefix:MISS
First Name:ABIGAIL
Middle Name:J
Last Name:MOTZ
Suffix:
Gender:F
Credentials:PRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2257 WAYNESBURG RD NW
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615-9319
Mailing Address - Country:US
Mailing Address - Phone:330-316-5776
Mailing Address - Fax:
Practice Address - Street 1:349 E HIGH AVE
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-2535
Practice Address - Country:US
Practice Address - Phone:330-364-1374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-04
Last Update Date:2019-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist