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NPI Code Detail

MEDICARE: KATIE LYNN GREENEY PT, DPT

MEDICARE: KATIE LYNN GREENEY PT, 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
1225100000XPhysical TherapistPT014654OH

General Provider Information

NPI Number : 1780457325
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE LYNN GREENEY PT, DPT
Provider Business Mailing Address
First Line : 1199 W CLIFTON BLVD
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-1054
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 26376 JOHN RD
Second Line :
City : OLMSTED TWP
State : OH
Zip : 44138-1277
Country : US
Telephone Number : 440-235-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2023
Last Update Date : 11/06/2023

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