Individual
MRS. TIFFANY STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, MPT
Contact information
Practice address
3983 JACKPOT RD, GROVE CITY, OH 43123-8637
(614) 539-5301
Mailing address
3983 JACKPOT RD, GROVE CITY, OH 43123
(614) 539-5301
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
011377
OH
2251X0800X
Orthopedic Physical Therapist
Primary
011377
OH
Other
Enumeration date
11/29/2007
Last updated
11/29/2007
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