Healthcare Provider Details

I. General information

NPI: 1285793273
Provider Name (Legal Business Name): KEITH W FILIP PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 EAST 101 ST CLEVELAND SIGHT CENTER
CLEVELAND OH
44106
US

IV. Provider business mailing address

11820 EDGEWATER DR #112
LAKEWOOD OH
44107-1767
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-8118
  • Fax: 216-795-5132
Mailing address:
  • Phone: 216-226-4861
  • Fax: 216-221-9801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number02621
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: