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General NPI Number Information
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NPI Number | 1619218435
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Entity Type | Individual
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Provider Name | ERIC PIETTE LMT
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Gender | Male
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 27700 EUCLID AVE # B
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City | EUCLID
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State | OH
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Zip | 44132-3531
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Country | US
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Telephone | 216-289-2632
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Fax | 216-289-2654
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Provider Business Mailing Address
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Address Line | 24932 AURORA RD STE C
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City | BEDFORD HEIGHTS
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State | OH
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Zip | 44146-1790
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Country | US
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Telephone | 440-439-9440
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Fax | 440-439-9447
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 33.019820
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License Number State | OH
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