Provider Demographics
NPI:1720682016
Name:GIRARD, JOEL (PTA)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:GIRARD
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 ROCKETS ST
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8015
Mailing Address - Country:US
Mailing Address - Phone:614-226-7085
Mailing Address - Fax:
Practice Address - Street 1:521 ROCKETS ST
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-8015
Practice Address - Country:US
Practice Address - Phone:614-226-7085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-26
Last Update Date:2020-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant