Healthcare Provider Details

I. General information

NPI: 1336531110
Provider Name (Legal Business Name): NATALIE KUCHTA PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2015
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7960 CENTER ST
MENTOR OH
44060-7863
US

IV. Provider business mailing address

5660 FRENCH BLVD
MENTOR OH
44060-1926
US

V. Phone/Fax

Practice location:
  • Phone: 440-299-6120
  • Fax:
Mailing address:
  • Phone: 330-353-4252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number015204
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: