MEDICARE: KATHRYN AYERS KANTURA P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	010707	OH

General Provider Information

NPI Number	:	1003152802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN AYERS KANTURA P.T.

Provider Business Mailing Address
First Line	:	6001 LANDERHAVEN DR
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44124-4190
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6001 LANDERHAVEN DR
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44124-4190
Country	:	US
Telephone Number	:	440-449-3400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2012
Last Update Date	:	12/26/2012

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