Provider Demographics
NPI:1306957113
Name:GRAMLICH, JENNIFER LEE (PT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:GRAMLICH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14707 SHAKER BLVD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1616
Mailing Address - Country:US
Mailing Address - Phone:216-932-2569
Mailing Address - Fax:
Practice Address - Street 1:5 SEVERANCE CIR
Practice Address - Street 2:SUITE 610
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1566
Practice Address - Country:US
Practice Address - Phone:216-658-3701
Practice Address - Fax:216-658-3802
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH006933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist