MEDICARE: CLEVELAND PHYSICAL THERAPY LTD.

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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1548406564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEVELAND PHYSICAL THERAPY LTD.

Provider Business Mailing Address
First Line	:	300 E HOUSTON ST
Second Line	:	SUITE A
City	:	CLEVELAND
State	:	TX
Zip	:	77327-4554
Country	:	US
Telephone Number	:	281-592-2884
Fax Number	:	281-592-3269

Provider Business Practice Location Address
First Line	:	300 E HOUSTON ST
Second Line	:	SUITE A
City	:	CLEVELAND
State	:	TX
Zip	:	77327-4554
Country	:	US
Telephone Number	:	281-592-2884
Fax Number	:	281-592-3269

Authorized Official
Title or Position	:	VP, AUTHORIZED OFFICIAL
Name	:	JANNA P KING
Credential	:	JD
Telephone Number	:	713-297-7000

Provider Enumeration Date	:	12/22/2008
Last Update Date	:	12/22/2008

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