Basic Information
| Provider Information | |||||||||
| NPI: | 1356571632 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOSAK | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 156 WEATHERSTONE DR | ||||||||
| Address2: | |||||||||
| City: | BEREA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440171091 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402683856 | ||||||||
| FaxNumber: | 4405721906 | ||||||||
| Practice Location | |||||||||
| Address1: | 18840 FALLING WATER RD | ||||||||
| Address2: | |||||||||
| City: | STRONGSVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441364200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402683856 | ||||||||
| FaxNumber: | 4405721906 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2009 | ||||||||
| LastUpdateDate: | 07/21/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 4103 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.