Provider Demographics
NPI:1972045185
Name:CANUP, PAULA (PTA)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:CANUP
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 GINDER RD NW
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-9179
Mailing Address - Country:US
Mailing Address - Phone:740-409-1684
Mailing Address - Fax:
Practice Address - Street 1:2469 STELZER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3129
Practice Address - Country:US
Practice Address - Phone:614-416-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program