Healthcare Provider Details

I. General information

NPI: 1467555482
Provider Name (Legal Business Name): MICHAEL M SUPLER & ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 SOUTH GREEN ROAD SUITE #036
SOUTH EUCLID OH
44121-4128
US

IV. Provider business mailing address

1611 SOUTH GREEN ROAD SUITE #036
SOUTH EUCLID OH
44121-4128
US

V. Phone/Fax

Practice location:
  • Phone: 216-291-2277
  • Fax: 216-291-5707
Mailing address:
  • Phone: 216-291-2277
  • Fax: 216-291-5707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MICHAEL MCGRAW SUPLER
Title or Position: PRESIDENT
Credential: PT
Phone: 216-291-2277