Healthcare Provider Details

I. General information

NPI: 1073217568
Provider Name (Legal Business Name): PATRICK CAWNEEN PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2049 E 100TH ST STE A40
CLEVELAND OH
44106-2104
US

IV. Provider business mailing address

5687 GRAVEN WAY
WADSWORTH OH
44281-8089
US

V. Phone/Fax

Practice location:
  • Phone: 216-645-4140
  • Fax:
Mailing address:
  • Phone: 440-622-8228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT019941
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: