Provider Demographics
NPI:1275779928
Name:SEROKA, TERESE A (PT)
Entity Type:Individual
Prefix:
First Name:TERESE
Middle Name:A
Last Name:SEROKA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 E AURORA RD # 218
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-2053
Mailing Address - Country:US
Mailing Address - Phone:330-998-2055
Mailing Address - Fax:
Practice Address - Street 1:154 E AURORA RD # 218
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-2053
Practice Address - Country:US
Practice Address - Phone:440-937-5210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-31
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 003732174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist