Provider Demographics
NPI:1932411931
Name:VOGEL, KASIMIRA (LMT)
Entity Type:Individual
Prefix:
First Name:KASIMIRA
Middle Name:
Last Name:VOGEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 GLADYS AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-2510
Mailing Address - Country:US
Mailing Address - Phone:216-235-0521
Mailing Address - Fax:
Practice Address - Street 1:3310 WARREN RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-2031
Practice Address - Country:US
Practice Address - Phone:216-476-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.018790T-Z225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist