Healthcare Provider Details

I. General information

NPI: 1356787964
Provider Name (Legal Business Name): ADVANCED ARM DYNAMICS OF CLEVELAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30701 CLEMENS RD SUITE C
WESTLAKE OH
44145-1074
US

IV. Provider business mailing address

123 W TORRANCE BLVD SUITE 203
REDONDO BEACH CA
90277-3610
US

V. Phone/Fax

Practice location:
  • Phone: 440-617-6601
  • Fax:
Mailing address:
  • Phone: 310-372-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOHN MIGUELEZ
Title or Position: PRESIDENT
Credential: CP
Phone: 310-372-3050