Provider Demographics
NPI:1477321818
Name:CLERE, KARLEIGH RENEE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KARLEIGH
Middle Name:RENEE
Last Name:CLERE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 HANNUM AVE
Mailing Address - Street 2:
Mailing Address - City:ROSSFORD
Mailing Address - State:OH
Mailing Address - Zip Code:43460-1111
Mailing Address - Country:US
Mailing Address - Phone:419-705-3370
Mailing Address - Fax:
Practice Address - Street 1:225 HANNUM AVE
Practice Address - Street 2:
Practice Address - City:ROSSFORD
Practice Address - State:OH
Practice Address - Zip Code:43460-1111
Practice Address - Country:US
Practice Address - Phone:419-705-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCP024809T225100000X
OHPT020657225100000X
COCP026963T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist