Healthcare Provider Details

I. General information

NPI: 1639820525
Provider Name (Legal Business Name): MISS LEAH CHRISTINE KOTHEIMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2022
Last Update Date: 01/12/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11175 SPERRY RD
CHESTERLAND OH
44026-1534
US

IV. Provider business mailing address

11175 SPERRY RD
CHESTERLAND OH
44026-1534
US

V. Phone/Fax

Practice location:
  • Phone: 440-371-4733
  • Fax:
Mailing address:
  • Phone: 440-371-4733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: