Provider Demographics
NPI:1821773888
Name:DO, MICHELLE THAO (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:THAO
Last Name:DO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5219 WILLOW GROVE PL S
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-2115
Mailing Address - Country:US
Mailing Address - Phone:614-599-0409
Mailing Address - Fax:
Practice Address - Street 1:5219 WILLOW GROVE PL S
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-2115
Practice Address - Country:US
Practice Address - Phone:614-599-0409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT0020512225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist