MEDICARE: CARLA DEPIETRO PT

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	225100000X	Physical Therapist	PT7553	OH

General Provider Information

NPI Number	:	1588292080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA DEPIETRO PT

Provider Business Mailing Address
First Line	:	7360 CARMEN DR NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-6222
Country	:	US
Telephone Number	:	330-495-3281
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 CANTON RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-4089
Country	:	US
Telephone Number	:	330-784-1271
Fax Number	:

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

Provider Enumeration Date	:	03/30/2020
Last Update Date	:	03/30/2020

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Directions to “ CARLA DEPIETRO PT” Practice Location

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