Healthcare Provider Details

I. General information

NPI: 1588647531
Provider Name (Legal Business Name): COWBOYS AND ANGELS THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5047 DUNSHA RD
MEDINA OH
44256-8483
US

IV. Provider business mailing address

5047 DUNSHA RD
MEDINA OH
44256-8483
US

V. Phone/Fax

Practice location:
  • Phone: 330-239-4491
  • Fax: 330-239-4490
Mailing address:
  • Phone: 330-239-4491
  • Fax: 330-239-4490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA FROST
Title or Position: OWNER/THERAPIST
Credential: OT
Phone: 330-239-4491