Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 7450 | OH |
Y | 2251X0800X | Physical Therapist - Orthopedic | 7450 | OH |
NPI | 1255750923 |
---|---|
Provider Name | Mr. Jeffrey Michael Sords |
First Address | Westlake, OH 44145-2345 |
Second Address | Garfield Heights, OH 44125-5371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2014 |
Last Update Date | 10/04/2014 |