Provider Demographics
NPI:1700844230
Name:STRYCHASZ, JONATHAN PAUL (PT)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:PAUL
Last Name:STRYCHASZ
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 1:5321 ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-4681
Mailing Address - Country:US
Mailing Address - Phone:216-986-1972
Mailing Address - Fax:216-485-7864
Practice Address - Street 1:25757 LORAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3370
Practice Address - Country:US
Practice Address - Phone:440-639-2229
Practice Address - Fax:440-639-2264
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2016-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.08441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHST41088Medicare PIN