Provider Demographics
NPI:1295941946
Name:WALTER, BETH LITTMAN (MPT)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:LITTMAN
Last Name:WALTER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:BETH
Other - Middle Name:LITTMAN
Other - Last Name:WALTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:160 DORRENCE RD
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-9444
Mailing Address - Country:US
Mailing Address - Phone:740-587-0520
Mailing Address - Fax:
Practice Address - Street 1:160 DORRENCE RD
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023-9444
Practice Address - Country:US
Practice Address - Phone:740-587-0520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT75152251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPT7515OtherSTATE LICENSURE NUMBER