Provider Demographics
NPI:1437182458
Name:AUBE, EDWARD JOSEPH (PT)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:AUBE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9360 MISTY OAKES DR
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-3123
Mailing Address - Country:US
Mailing Address - Phone:440-526-8566
Mailing Address - Fax:440-546-8280
Practice Address - Street 1:7000 TOWN CENTRE DR
Practice Address - Street 2:SUITE 400
Practice Address - City:BROADVIEW HTS
Practice Address - State:OH
Practice Address - Zip Code:44147-4008
Practice Address - Country:US
Practice Address - Phone:440-526-8566
Practice Address - Fax:440-546-8280
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 038322251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH137837OtherANTHEM
OH2188145Medicaid
OH2188145Medicaid