Healthcare Provider Details

I. General information

NPI: 1255304275
Provider Name (Legal Business Name): ROBERT VINCENT LEIMKUEHLER C. P. O.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5403 MAYFIELD RD
LYNDHURST OH
44124-2911
US

IV. Provider business mailing address

4625 DETROIT AVE
CLEVELAND OH
44102-2214
US

V. Phone/Fax

Practice location:
  • Phone: 440-442-0454
  • Fax: 440-442-0597
Mailing address:
  • Phone: 216-651-7788
  • Fax: 216-651-4057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: