MEDICARE: HALLIE KANIA PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	PTA013827	OH

General Provider Information

NPI Number	:	1275483638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALLIE KANIA PTA

Provider Business Mailing Address
First Line	:	7257 CENTER ST
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-4907
Country	:	US
Telephone Number	:	440-740-8877
Fax Number	:	440-740-8844

Provider Business Practice Location Address
First Line	:	7257 CENTER ST
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-4907
Country	:	US
Telephone Number	:	440-740-8877
Fax Number	:	440-740-8844

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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Directions to “ HALLIE KANIA PTA” Practice Location

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