Provider Demographics
NPI:1487452454
Name:LEIMKUEHLER, GREGORY (CPO)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:LEIMKUEHLER
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-2295
Mailing Address - Country:US
Mailing Address - Phone:216-651-7788
Mailing Address - Fax:216-651-4057
Practice Address - Street 1:4625 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-2295
Practice Address - Country:US
Practice Address - Phone:216-651-7788
Practice Address - Fax:216-651-4057
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00287222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist