Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1702 | OH |
NPI | 1902910813 |
---|---|
Provider Name | Miss Angela L Hejduk |
First Address | Willowick, OH 44095-3418 |
Second Address | Cleveland, OH 44115-1313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 08/07/2007 |