Provider Demographics
NPI:1790838985
Name:OVER, MARIAN SLAGLE (PT)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:SLAGLE
Last Name:OVER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:8180 WILHITE DR
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-9265
Mailing Address - Country:US
Mailing Address - Phone:330-335-3161
Mailing Address - Fax:330-966-6586
Practice Address - Street 1:6200 FRANK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7228
Practice Address - Country:US
Practice Address - Phone:330-966-5458
Practice Address - Fax:330-966-6586
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH002739225100000X, 2251C2600X, 2251H1300X, 2251N0400X, 2251S0007X, 2251X0800X
OHPT0027392251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonary
Not Answered2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Not Answered2251H1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHuman Factors
Not Answered2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Not Answered2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic