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Individual

STEPHEN KELBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.P.A.

Contact information

Practice address
3999 RICHMOND RD, BEACHWOOD, OH 44122-6046
(216) 593-5500
Mailing address
3999 RICHMOND RD, BEACHWOOD, OH 44122-6046
(216) 593-5500

Taxonomy

Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
68.000011
OH
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
R8859468
OH

Other

Enumeration date
06/19/2015
Last updated
06/19/2015
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