Basic Information
| Provider Information | |||||||||
| NPI: | 1871076414 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOUDEK | ||||||||
| FirstName: | ZACHARY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15795 LAKEVIEW TER | ||||||||
| Address2: | |||||||||
| City: | MIDDLEBURG HEIGHTS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441308398 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2169787701 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4807 ROCKSIDE RD | ||||||||
| Address2: | |||||||||
| City: | INDEPENDENCE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441312192 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2169011464 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2018 | ||||||||
| LastUpdateDate: | 09/10/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.