Healthcare Provider Details

I. General information

NPI: 1821414327
Provider Name (Legal Business Name): PATRICK MICHAEL RODKEY PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2014
Last Update Date: 03/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21225 LORAIN RD CLEVELAND CLINIC REHAB AND SPORTS THERAPY
FAIRVIEW PARK OH
44126-2120
US

IV. Provider business mailing address

837 HORSESHOE WAY
AVON LAKE OH
44012-4029
US

V. Phone/Fax

Practice location:
  • Phone: 440-331-3180
  • Fax: 440-331-3183
Mailing address:
  • Phone: 440-258-3014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number08897
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: