Individual
GLENN EUGENE KERSHAW JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
9002 MENTOR AVE, MENTOR, OH 44060-6302
(440) 266-1901
(440) 266-1902
Mailing address
9002 MENTOR AVE, MENTOR, OH 44060-6302
(440) 266-1901
(440) 266-1902
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
03121
OH
Other
Enumeration date
10/22/2008
Last updated
10/22/2008
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