Provider Demographics
NPI:1013806173
Name:COACH TEE'S BOXING ACADEMY
Entity type:Organization
Organization Name:COACH TEE'S BOXING ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JAPARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GERMANY
Authorized Official - Suffix:
Authorized Official - Credentials:CDCA,CPRS
Authorized Official - Phone:216-400-3315
Mailing Address - Street 1:932 LONDON RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-3116
Mailing Address - Country:US
Mailing Address - Phone:216-394-4648
Mailing Address - Fax:
Practice Address - Street 1:20001 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44117-1480
Practice Address - Country:US
Practice Address - Phone:216-465-9942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty