Provider Demographics
NPI:1427658426
Name:SLUSARZ, CALLAWAY BENJAMIN (DPT)
Entity type:Individual
Prefix:DR
First Name:CALLAWAY
Middle Name:BENJAMIN
Last Name:SLUSARZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11906 MEADOWRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-1834
Mailing Address - Country:US
Mailing Address - Phone:440-539-7393
Mailing Address - Fax:
Practice Address - Street 1:8881 SCHAEFFER ST
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5035
Practice Address - Country:US
Practice Address - Phone:440-255-9309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT018567225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist