Provider Demographics
NPI:1679523195
Name:ALBERT, MICHELLE M (PT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:ALBERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23825 COMMERCE PARK
Mailing Address - Street 2:STE B
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5837
Mailing Address - Country:US
Mailing Address - Phone:216-292-6363
Mailing Address - Fax:216-292-6306
Practice Address - Street 1:4330 W 150TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135-1362
Practice Address - Country:US
Practice Address - Phone:216-688-0901
Practice Address - Fax:216-688-0905
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT08094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist