Individual
MS. TERESA LYNN BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA, LNHA
Contact information
Practice address
5069 OTTERBEIN WAY, MONCLOVA, OH 43542-8500
(419) 878-0550
Mailing address
22898 PARGILLIS RD, PERRYSBURG, OH 43551-9606
(419) 340-2107
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002728
OH
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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