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General NPI Number Information
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NPI Number | 1023277233
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Entity Type | Individual
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Provider Name | JESSICA MARIE BROZ P.T.
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Gender | Female
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 30033 CLEMENS RD
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City | WESTLAKE
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State | OH
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Zip | 44145-1021
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Country | US
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Telephone | 440-899-5625
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Fax |
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Provider Business Mailing Address
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Address Line | 1580 LINCOLN AVE
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City | LAKEWOOD
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State | OH
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Zip | 44107-4437
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Country | US
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Telephone | 440-570-1457
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 09801
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License Number State | OH
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