Provider Demographics
NPI:1528270485
Name:ROADMAN, DENISE L (ATC, PA-C)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:L
Last Name:ROADMAN
Suffix:
Gender:F
Credentials:ATC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1900 23RD ST
Mailing Address - Street 2:PAIN CENTER
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-1404
Mailing Address - Country:US
Mailing Address - Phone:330-971-7246
Mailing Address - Fax:330-971-7256
Practice Address - Street 1:1900 23RD ST
Practice Address - Street 2:PAIN CENTER
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-1404
Practice Address - Country:US
Practice Address - Phone:330-971-7246
Practice Address - Fax:330-971-7256
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0012322255A2300X
OH004174363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer