MEDICARE: LCA CLEVELAND

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	247200000X	Other Technician

General Provider Information

NPI Number	:	1134669765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LCA CLEVELAND

Provider Business Mailing Address
First Line	:	7055 ENGLE RD
Second Line	:	BLDG 6 SUITE 605
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-8491
Country	:	US
Telephone Number	:	216-533-7771
Fax Number	:

Provider Business Practice Location Address
First Line	:	7055 ENGLE RD
Second Line	:	BLDG 6 SUITE 605
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-8491
Country	:	US
Telephone Number	:	216-533-7771
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	AISHA GASE
Credential	:
Telephone Number	:	216-533-7771

Provider Enumeration Date	:	03/01/2017
Last Update Date	:	03/01/2017

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Directions to “LCA CLEVELAND ” Practice Location

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