MEDICARE: SARATU JUBLOU

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	PT. 014939	OH

General Provider Information

NPI Number	:	1952703555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARATU JUBLOU

Provider Business Mailing Address
First Line	:	3290 BRADFORD RD
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44118-4228
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 RICHMOND RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-5984
Country	:	US
Telephone Number	:	216-378-9390
Fax Number	:

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

Provider Enumeration Date	:	09/25/2014
Last Update Date	:	03/17/2018

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Directions to “ SARATU JUBLOU ” Practice Location

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