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General NPI Number Information
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NPI Number | 1245656990
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Entity Type | Individual
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Provider Name | DAMIAN KETER
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Gender | Male
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Dates
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Enumeration Date | 03/05/2014
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 10701 EAST BLVD
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City | CLEVELAND
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State | OH
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Zip | 44106-1702
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Country | US
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Telephone | 216-791-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 17914 CREST LN
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City | LAKEWOOD
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State | OH
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Zip | 44107-3523
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Country | US
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Telephone | 330-242-0042
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT014647
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License Number State | OH
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