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General NPI Number Information
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NPI Number | 1730365974
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Entity Type | Organization
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Legal Business Name | CARMEN J. AMADIO JR
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 170 BOARDMAN CANFIELD RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44512-4855
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Country | US
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Telephone | 330-758-4011
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Fax |
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Provider Business Mailing Address
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Address Line | 170 BOARDMAN CANFIELD RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44512-4855
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Country | US
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Telephone | 330-758-4011
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. CARMEN J AMADIO JR.
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Credential | L.PED, C.PED, O.S.T.
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Telephone | 330-758-4011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 0001
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License Number State | OH
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