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General NPI Number Information
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NPI Number | 1023892296
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Entity Type | Organization
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Legal Business Name | SUPLER OSTEOPRACTIC PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 08/21/2023
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Provider Practice Location Address
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Address Line | 5412 MAYFIELD RD
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City | LYNDHURST
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State | OH
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Zip | 44124-2941
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Country | US
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Telephone | 216-200-8043
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Fax |
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Provider Business Mailing Address
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Address Line | 2304 MIRAMAR BLVD
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City | UNIVERSITY HEIGHTS
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State | OH
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Zip | 44118-3819
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Country | US
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Telephone | 216-287-3085
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RYAN SUPLER
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Credential | PT, DPT
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Telephone | 216-200-8043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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