Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | LPO.00361 | OH |
N | 222Z00000X | Podiatrist | LPO.00361 | OH |
Y | 224P00000X | Prosthetist | LPO.00361 | OH |
NPI | 1073199238 |
---|---|
Provider Name | Christopher Bear Testa |
First Address | Cleveland, OH 44102-3345 |
Second Address | Cleveland, OH 44102-3345 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2021 |
Last Update Date | 19/03/2021 |