Provider Demographics
NPI:1811689805
Name:MONKIEWICZ, MICHELLE ORA (DPT)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ORA
Last Name:MONKIEWICZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 COURT ST
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-1209
Mailing Address - Country:US
Mailing Address - Phone:716-598-3360
Mailing Address - Fax:
Practice Address - Street 1:13000 AUBURN RD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-9337
Practice Address - Country:US
Practice Address - Phone:440-286-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10155225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist