Healthcare Provider Details

I. General information

NPI: 1831114404
Provider Name (Legal Business Name): ELIZABETH LINN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH FEDOR

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4180 WARRENSVILLE CENTER RD
BEACHWOOD OH
44122-7012
US

IV. Provider business mailing address

20000 HARVARD AVE
WARRENSVILLE HEIGHTS OH
44122-6805
US

V. Phone/Fax

Practice location:
  • Phone: 216-491-6180
  • Fax:
Mailing address:
  • Phone: 216-491-6180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05007298A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT011902
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: