Provider Demographics
NPI:1841521325
Name:TROYER, ELISABETH GRACE
Entity type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:GRACE
Last Name:TROYER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:GRACE
Other - Last Name:TROYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:3600 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1475
Mailing Address - Country:US
Mailing Address - Phone:614-330-7418
Mailing Address - Fax:
Practice Address - Street 1:3600 MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1475
Practice Address - Country:US
Practice Address - Phone:614-330-7418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.015486172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist