Provider Demographics
NPI:1942541479
Name:ORZELL, BETH (LPO/CPO)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:ORZELL
Suffix:
Gender:F
Credentials:LPO/CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 NORTH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-1900
Mailing Address - Country:US
Mailing Address - Phone:330-633-9807
Mailing Address - Fax:330-633-9480
Practice Address - Street 1:33 NORTH AVE STE 201
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-1900
Practice Address - Country:US
Practice Address - Phone:330-633-9807
Practice Address - Fax:330-633-9480
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
OHLO35222Z00000X
OHLP84224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2002853Medicaid