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NPI Code Detail

MEDICARE: LUKE ROSENDALE PT, DPT

MEDICARE: LUKE ROSENDALE PT, DPT
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 Therapist021112OH

General Provider Information

NPI Number : 1538903398
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUKE ROSENDALE PT, DPT
Provider Business Mailing Address
First Line : 4293 BEVERLY HILLS DR APT 164
Second Line :
City : BRUNSWICK
State : OH
Zip : 44212-1629
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10701 EAST BLVD
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1702
Country : US
Telephone Number : 216-791-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2024
Last Update Date : 06/25/2024

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Directions to “ LUKE ROSENDALE PT, DPT” Practice Location

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