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General NPI Number Information
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NPI Number | 1104225549
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Entity Type | Organization
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Legal Business Name | MANGIARELLI REHABILITATION, LLC
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 8935 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44484-2353
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Country | US
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Telephone | 330-393-0079
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Fax | 330-393-0005
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Provider Business Mailing Address
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Address Line | 8935 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44484-2353
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Country | US
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Telephone | 330-393-0079
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Fax | 330-393-0005
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MRS. PAULA KAY MANGIARELLI
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Credential | PT
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Telephone | 330-393-0079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 015034
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License Number State | OH
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