Healthcare Provider Details

I. General information

NPI: 1609822337
Provider Name (Legal Business Name): BETH S BEDNAR P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BETH S BARNOSKI P.T.

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12656 W GEAUGA PLZ
CHESTERLAND OH
44026-2505
US

IV. Provider business mailing address

12656 WEST GEAUGA PLAZA
CHESTERLAND OH
44026-2505
US

V. Phone/Fax

Practice location:
  • Phone: 440-688-4186
  • Fax: 440-688-4187
Mailing address:
  • Phone: 440-688-4186
  • Fax: 440-688-4187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT007830
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: