Basic Information
| Provider Information | |||||||||
| NPI: | 1396848370 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STRAZAR | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PT, DPT, SCS, ATC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | STRAZAR-SAUNDERS | ||||||||
| OtherFirstName: | PATRICIA | ||||||||
| OtherMiddleName: | JEAN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PT, MS, SCS, ATC | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2546 CENTER RD | ||||||||
| Address2: | |||||||||
| City: | HINCKLEY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442339561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3305580100 | ||||||||
| FaxNumber: | 3305580110 | ||||||||
| Practice Location | |||||||||
| Address1: | 2546 CENTER RD | ||||||||
| Address2: | |||||||||
| City: | HINCKLEY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442339561 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3305580100 | ||||||||
| FaxNumber: | 3305580110 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2006 | ||||||||
| LastUpdateDate: | 01/11/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT-4291 | OH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 2255A2300X | OH-00344 | OH | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer | 2251S0007X | PT-4291 | OH | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports |
ID Information
| ID | Type | State | Issuer | Description | 2337224 | 05 | OH | MEDICAID |