Provider Demographics
NPI:1407845670
Name:KNETTLE, MARI A (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARI
Middle Name:A
Last Name:KNETTLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARI
Other - Middle Name:
Other - Last Name:MORDARSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4670 RICHMOND RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-6410
Mailing Address - Country:US
Mailing Address - Phone:216-378-9390
Mailing Address - Fax:216-378-9379
Practice Address - Street 1:4670 RICHMOND RD
Practice Address - Street 2:SUITE 250
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-6410
Practice Address - Country:US
Practice Address - Phone:216-378-9390
Practice Address - Fax:216-378-9379
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.89292251E1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics