Provider Demographics
NPI:1891023453
Name:ABEL, BOBBIE JO (PT)
Entity Type:Individual
Prefix:MRS
First Name:BOBBIE
Middle Name:JO
Last Name:ABEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:959 ILLINOIS AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1743
Mailing Address - Country:US
Mailing Address - Phone:419-482-6519
Mailing Address - Fax:419-482-6832
Practice Address - Street 1:959 ILLINOIS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1743
Practice Address - Country:US
Practice Address - Phone:419-482-6519
Practice Address - Fax:419-482-6832
Is Sole Proprietor?:No
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT8957225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist