MEDICARE: MR. EDWARD JOSEPH AUBE 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	2251X0800X	Orthopedic Physical Therapist	PT 03832	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	137837	OTHER	OH	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437182458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARD JOSEPH AUBE P.T.

Provider Business Mailing Address
First Line	:	9360 MISTY OAKES DR
Second Line	:
City	:	BROADVIEW HTS
State	:	OH
Zip	:	44147-3123
Country	:	US
Telephone Number	:	440-526-8566
Fax Number	:	440-546-8280

Provider Business Practice Location Address
First Line	:	7000 TOWN CENTRE DR
Second Line	:	SUITE 400
City	:	BROADVIEW HTS
State	:	OH
Zip	:	44147-4008
Country	:	US
Telephone Number	:	440-526-8566
Fax Number	:	440-546-8280

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/09/2007

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