Provider Demographics
NPI:1346222148
Name:KINSER, RICKIE LEE (PT, DIP MDT)
Entity type:Individual
Prefix:
First Name:RICKIE
Middle Name:LEE
Last Name:KINSER
Suffix:
Gender:M
Credentials:PT, DIP MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30455 SOLON RD
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-3458
Mailing Address - Country:US
Mailing Address - Phone:440-498-9723
Mailing Address - Fax:440-498-9725
Practice Address - Street 1:30455 SOLON RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-3458
Practice Address - Country:US
Practice Address - Phone:440-498-9723
Practice Address - Fax:440-498-9725
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH059492251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic