Provider Demographics
NPI:1558899690
Name:GUDEL, JOSEPH F
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:F
Last Name:GUDEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6332 MELSHORE DR
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-2344
Mailing Address - Country:US
Mailing Address - Phone:440-840-9201
Mailing Address - Fax:
Practice Address - Street 1:6332 MELSHORE DR
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-2344
Practice Address - Country:US
Practice Address - Phone:440-840-9201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT016203225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist