Provider Demographics
NPI:1205277852
Name:PLUMMER, MARY CLAIRE (PT, DPT, AT)
Entity type:Individual
Prefix:DR
First Name:MARY CLAIRE
Middle Name:
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:PT, DPT, AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 E TOWN ST
Mailing Address - Street 2:APARTMENT 31
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4863
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3900 STONERIDGE LN
Practice Address - Street 2:SUITE C
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-2288
Practice Address - Country:US
Practice Address - Phone:614-366-9324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0137512251S0007X
OH0031202255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer