Doctor Name: | RICHARD JAMES VILT |
NPI Number: | 1356764963 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 33.017418 |
Business Practice Address: | 9772 Diagonal Rd Outreach Academy Mantua, OH - 442559128 |
Business Phone Number: | 3302742272 |
Business Fax Number: | |
Mailing Address: | 3727 Bosworth Rd, Outreach Academy CLEVELAND |
State: | OH |
Postal Code: | 441116037 |
Phone Number: | 3302742272 |
Fax Number: | |
NPI Enumeration Date: | 02/03/2014 |
NPI Last Update Date: | 09/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 33.017418 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |