Individual
MRS. KATHLEEN RAE EZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
14519 DETROIT AVE, LAKEWOOD, OH 44107-4316
(216) 521-4200
Mailing address
14519 DETROIT AVE, LAKEWOOD, OH 44107-4316
(216) 521-4200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04641
OH
Other
Enumeration date
04/01/2014
Last updated
04/01/2014
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