Provider Demographics
NPI:1871206607
Name:EDDINGTON, TORI MICHELLE (PTA)
Entity type:Individual
Prefix:MISS
First Name:TORI
Middle Name:MICHELLE
Last Name:EDDINGTON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 JOHN GLENN RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-2412
Mailing Address - Country:US
Mailing Address - Phone:937-271-7693
Mailing Address - Fax:
Practice Address - Street 1:5070 LAMME RD
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-3266
Practice Address - Country:US
Practice Address - Phone:937-293-7703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA012739225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant