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General NPI Number Information
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NPI Number | 1477847937
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Entity Type | Individual
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Provider Name | ROBERT E COLDIRON LPTA
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Gender | Male
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 06/01/2011
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Provider Practice Location Address
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Address Line | 15435 BAGLEY RD
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City | CLEVELAND
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State | OH
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Zip | 44130-4827
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Country | US
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Telephone | 440-887-1395
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Fax |
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Provider Business Mailing Address
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Address Line | 2364 CONRAD ST
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City | AVON
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State | OH
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Zip | 44011-5216
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Country | US
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Telephone | 440-668-0657
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 00887
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License Number State | OH
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