Healthcare Provider Details

I. General information

NPI: 1093737314
Provider Name (Legal Business Name): MAUREEN PARNIN SIZEMORE ATC, PTA, EMT-B
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 W 30TH ST
CLEVELAND OH
44113-3495
US

IV. Provider business mailing address

4494 LILAC RD
SOUTH EUCLID OH
44121-3903
US

V. Phone/Fax

Practice location:
  • Phone: 216-651-0222
  • Fax:
Mailing address:
  • Phone: 216-291-4934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT00537
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: