Provider Demographics
NPI:1932527611
Name:STRODTBECK, KYLE
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:STRODTBECK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 SUNNYCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-1135
Mailing Address - Country:US
Mailing Address - Phone:216-990-9909
Mailing Address - Fax:
Practice Address - Street 1:71 SUNNYCLIFF DR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-1135
Practice Address - Country:US
Practice Address - Phone:216-990-9909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program