MEDICARE: KATHERINE JOYCE CHAE DPT

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	PT016399	OH

General Provider Information

NPI Number	:	1083136741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE JOYCE CHAE DPT

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE # C22
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:	573-355-3124
Fax Number	:

Provider Business Practice Location Address
First Line	:	10524 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-2205
Country	:	US
Telephone Number	:	216-445-4832
Fax Number	:

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

Provider Enumeration Date	:	07/13/2017
Last Update Date	:	07/13/2017

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