Healthcare Provider Details

I. General information

NPI: 1467579367
Provider Name (Legal Business Name): JODI ANN KEIPER OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10204 GRANGER RD
CLEVELAND OH
44125-3106
US

IV. Provider business mailing address

39 W BELMEADOW LN
CHAGRIN FALLS OH
44022-4221
US

V. Phone/Fax

Practice location:
  • Phone: 216-581-2900
  • Fax:
Mailing address:
  • Phone: 440-338-1803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number003275
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: