Provider Demographics
NPI:1801521356
Name:SUMMERS, CECELIA ELIZABETH (PT, DPT)
Entity type:Individual
Prefix:
First Name:CECELIA
Middle Name:ELIZABETH
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:CECELIA
Other - Middle Name:ELIZABETH
Other - Last Name:WALLACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:7255 ERVIN RD APT A
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-3523
Mailing Address - Country:US
Mailing Address - Phone:740-593-1000
Mailing Address - Fax:
Practice Address - Street 1:7255 ERVIN RD APT A
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-3523
Practice Address - Country:US
Practice Address - Phone:740-593-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305215153225100000X
OHPT019956225100000X
225100000X
NHCP014782T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist