Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 10149 | OH |
NPI | 1598184392 |
---|---|
Provider Name | Kelly Nye Sutherland |
First Address | Rocky River, OH 44116-2864 |
Second Address | Strongsville, OH 44136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2014 |
Last Update Date | 09/04/2014 |