Provider Demographics
NPI:1609822337
Name:BEDNAR, BETH S (PT)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:S
Last Name:BEDNAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:S
Other - Last Name:BARNOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:12656 WEST GEAUGA PLAZA
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2505
Mailing Address - Country:US
Mailing Address - Phone:440-688-4186
Mailing Address - Fax:440-688-4187
Practice Address - Street 1:12656 W GEAUGA PLZ
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-2505
Practice Address - Country:US
Practice Address - Phone:440-688-4186
Practice Address - Fax:440-688-4187
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT007830225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist