Healthcare Provider Details

I. General information

NPI: 1689093999
Provider Name (Legal Business Name): JEFFREY J CIOLEK PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-3452
  • Fax: 216-444-8548
Mailing address:
  • Phone: 216-444-3452
  • Fax: 216-444-8548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2949
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: