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Individual
MR. MICHAEL V FARRIS
Active
Individual
MR. MICHAEL V FARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-09049
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000369084
ANTHEM BCBS
OH
05
—
2536385
—
OH
01
—
341783341027
CARESOURCE
OH
Enumeration date
03/08/2006
Last updated
03/02/2021
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