Healthcare Provider Details

I. General information

NPI: 1831027861
Provider Name (Legal Business Name): MOHANNAD YUSUF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4389 MEDINA RD
COPLEY OH
44321-1388
US

IV. Provider business mailing address

5223 CLINE RD UNIT D
KENT OH
44240-7075
US

V. Phone/Fax

Practice location:
  • Phone: 234-815-5100
  • Fax:
Mailing address:
  • Phone: 330-240-4177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT022357
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: