Healthcare Provider Details

I. General information

NPI: 1073764999
Provider Name (Legal Business Name): SAMANTHA ANN KUHN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 10/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22308 LAKESHORE
EUCLID OH
44123
US

IV. Provider business mailing address

22308 LAKESHORE BLVD
EUCLID OH
44123
US

V. Phone/Fax

Practice location:
  • Phone: 216-289-2500
  • Fax: 216-289-2585
Mailing address:
  • Phone: 216-289-2500
  • Fax: 216-289-2585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.015784
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: