Provider Demographics
NPI:1134542236
Name:MOGYORDY THERAPY CLINIC LLC
Entity type:Organization
Organization Name:MOGYORDY THERAPY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KOVATS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-892-5367
Mailing Address - Street 1:26927 DETROIT RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2370
Mailing Address - Country:US
Mailing Address - Phone:440-892-5367
Mailing Address - Fax:440-249-5094
Practice Address - Street 1:26927 DETROIT RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2370
Practice Address - Country:US
Practice Address - Phone:440-892-5367
Practice Address - Fax:440-249-5094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-24
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6259152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1518254572OtherDR. STEELE NPI