Provider Demographics
NPI:1497724454
Name:WARRENDER, ERIN DANA (MPT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:DANA
Last Name:WARRENDER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 NILES CORTLAND RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-3510
Mailing Address - Country:US
Mailing Address - Phone:330-505-9275
Mailing Address - Fax:330-505-9306
Practice Address - Street 1:1160 NILES CORTLAND RD
Practice Address - Street 2:SUITE A
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-3510
Practice Address - Country:US
Practice Address - Phone:330-505-9275
Practice Address - Fax:330-505-9306
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT011156225100000X
PAPT015507225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2595866Medicaid
OHWA4164144Medicare PIN
OHWA4164143Medicare PIN