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NPI Code Detail

MEDICARE: MR. JOSEPH BANDURA

MEDICARE: MR. JOSEPH BANDURA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT - 7277OH

General Provider Information

NPI Number : 1023073129
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH BANDURA
Provider Business Mailing Address
First Line : 4262 WINDMILL CT
Second Line :
City : MEDINA
State : OH
Zip : 44256-6920
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15900 SNOW RD
Second Line : SUITE 500
City : BROOKPARK
State : OH
Zip : 44142-2859
Country : US
Telephone Number : 216-265-3454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 07/08/2007

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Directions to “ MR. JOSEPH BANDURA ” Practice Location

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