Provider Demographics
NPI:1518392877
Name:THE CLEVELAND CLINIC
Entity Type:Organization
Organization Name:THE CLEVELAND CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED ATHLETIC TRAINER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BUTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:ATC
Authorized Official - Phone:330-304-2482
Mailing Address - Street 1:2111 ABBEYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:OH
Mailing Address - Zip Code:44280-9537
Mailing Address - Country:US
Mailing Address - Phone:330-304-2482
Mailing Address - Fax:
Practice Address - Street 1:2111 ABBEYVILLE RD
Practice Address - Street 2:
Practice Address - City:VALLEY CITY
Practice Address - State:OH
Practice Address - Zip Code:44280-9537
Practice Address - Country:US
Practice Address - Phone:330-304-2482
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH004135282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital