Provider Demographics
NPI:1093032120
Name:LIPSTREU, JANET RUTH (MT)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:RUTH
Last Name:LIPSTREU
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 YELLOWSTONE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44121-1372
Mailing Address - Country:US
Mailing Address - Phone:330-606-8728
Mailing Address - Fax:
Practice Address - Street 1:895 YELLOWSTONE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44121-1372
Practice Address - Country:US
Practice Address - Phone:330-606-8728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.016304 L-M225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist