Provider Demographics
NPI:1114600954
Name:PLUTA, TIFFANY ANN (DR)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANN
Last Name:PLUTA
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 GARNETT CIR
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-1013
Mailing Address - Country:US
Mailing Address - Phone:440-623-4410
Mailing Address - Fax:
Practice Address - Street 1:46 GARNETT CIR
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-1013
Practice Address - Country:US
Practice Address - Phone:440-623-4410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0122622251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics