Provider Demographics
NPI:1922349455
Name:KUEHN, JEFFREY (CP)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:KUEHN
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 N HOLLAND SYLVANIA RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1411
Mailing Address - Country:US
Mailing Address - Phone:419-841-9852
Mailing Address - Fax:419-843-2727
Practice Address - Street 1:3435 N HOLLAND SYLVANIA RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1411
Practice Address - Country:US
Practice Address - Phone:419-841-9852
Practice Address - Fax:419-843-2727
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLP61224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2225121Medicaid