Provider Demographics
NPI:1851626550
Name:SOMMERS, BETH ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANN
Last Name:SOMMERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8189 S BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-2026
Mailing Address - Country:US
Mailing Address - Phone:330-388-3968
Mailing Address - Fax:216-901-2803
Practice Address - Street 1:997 W AURORA RD
Practice Address - Street 2:
Practice Address - City:SAGAMORE HILLS
Practice Address - State:OH
Practice Address - Zip Code:44067-4602
Practice Address - Country:US
Practice Address - Phone:330-468-2904
Practice Address - Fax:330-468-2905
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT003912225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH13624437OtherCAQH