Provider Demographics
NPI:1043945603
Name:RICE, DANA JO (MT)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:JO
Last Name:RICE
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:BUBEMYRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT
Mailing Address - Street 1:6531 WINFORD AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-0548
Mailing Address - Country:US
Mailing Address - Phone:513-863-2273
Mailing Address - Fax:513-863-6022
Practice Address - Street 1:6531 WINFORD AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-0548
Practice Address - Country:US
Practice Address - Phone:513-863-2273
Practice Address - Fax:513-863-6022
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist