MEDICARE: MR. MICHAEL B LEPP PT

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	1572	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700950185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL B LEPP PT

Provider Business Mailing Address
First Line	:	781 BETA DR
Second Line	:	SUITE C
City	:	CLEVELAND
State	:	OH
Zip	:	44143-2356
Country	:	US
Telephone Number	:	440-440-7111
Fax Number	:	440-460-1767

Provider Business Practice Location Address
First Line	:	781 BETA DR
Second Line	:	SUITE C
City	:	CLEVELAND
State	:	OH
Zip	:	44143-2356
Country	:	US
Telephone Number	:	440-440-7111
Fax Number	:	440-460-1767

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	05/22/2008

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