Individual
MRS. BAMBI LYNN SHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
9772 DIAGONAL RD, MANTUA, OH 44255-9128
(330) 274-2272
Mailing address
5123 COLDBROOK DR, MANTUA, OH 44255-9246
(330) 274-3355
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
01008
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1BSHEA5123
—
OH
Enumeration date
07/31/2006
Last updated
07/08/2007
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