MEDICARE: TIMOTHY HINCHLIFFE PTA

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1770771677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY HINCHLIFFE PTA

Provider Business Mailing Address
First Line	:	4511 ROCKSIDE RD
Second Line	:	STE 330
City	:	CLEVELAND
State	:	OH
Zip	:	44131-2199
Country	:	US
Telephone Number	:	216-901-0400
Fax Number	:	216-901-0401

Provider Business Practice Location Address
First Line	:	4511 ROCKSIDE RD
Second Line	:	STE 330
City	:	CLEVELAND
State	:	OH
Zip	:	44131-2199
Country	:	US
Telephone Number	:	216-901-0400
Fax Number	:	216-901-0401

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

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	10/05/2007

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Directions to “ TIMOTHY HINCHLIFFE PTA” Practice Location

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