Provider Demographics
NPI:1144228867
Name:VOLANSKY, KERRY (DSC, PT, MBA, OCS)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:
Last Name:VOLANSKY
Suffix:
Gender:F
Credentials:DSC, PT, MBA, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 TOURNAMENT DR
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-2284
Mailing Address - Country:US
Mailing Address - Phone:440-933-6855
Mailing Address - Fax:440-933-6855
Practice Address - Street 1:602 TOURNAMENT DR
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-2284
Practice Address - Country:US
Practice Address - Phone:440-933-6855
Practice Address - Fax:440-933-6855
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT05847225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4267401Medicare PIN