Healthcare Provider Details

I. General information

NPI: 1730509878
Provider Name (Legal Business Name): LYNEAH JEAN HUFF P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2014
Last Update Date: 04/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18901 LAKE SHORE BLVD
EUCLID OH
44119-1078
US

IV. Provider business mailing address

18901 LAKE SHORE BLVD
EUCLID OH
44119-1078
US

V. Phone/Fax

Practice location:
  • Phone: 216-692-7693
  • Fax:
Mailing address:
  • Phone: 216-692-7693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number0H-2786
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: