Individual
ALICIA LYNN NIEBAUER
Active
Individual
ALICIA LYNN NIEBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT09375
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000539369
ANTHEM
OH
05
—
2579893
—
OH
01
—
PT09375
PT STATE LICENSE
OH
Enumeration date
03/08/2006
Last updated
09/30/2013
Update your record
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