Provider Demographics
NPI:1366558520
Name:FOLEY, RITA ROANTREE (PA-C)
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:ROANTREE
Last Name:FOLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:ANN
Other - Last Name:ROANTREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 PERKINS SQ
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-1063
Mailing Address - Country:US
Mailing Address - Phone:419-522-3341
Mailing Address - Fax:419-522-1110
Practice Address - Street 1:770 BALGREEN DR STE 101
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-4106
Practice Address - Country:US
Practice Address - Phone:419-522-3341
Practice Address - Fax:419-522-1110
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.002402RX363A00000X
OH50.002402363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Not Answered363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical