MEDICARE: MRS. JENNIFER JO ZOCCHI P.T.A.

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	PTA 03796	OH

General Provider Information

NPI Number	:	1043354467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER JO ZOCCHI P.T.A.

Provider Business Mailing Address
First Line	:	1331 BEECHVIEW DR
Second Line	:
City	:	VERMILION
State	:	OH
Zip	:	44089-1605
Country	:	US
Telephone Number	:	440-967-0277
Fax Number	:

Provider Business Practice Location Address
First Line	:	4511 ROCKSIDE RD
Second Line	:	SUITE 330
City	:	INDEPENDENCE
State	:	OH
Zip	:	44131-2199
Country	:	US
Telephone Number	:	877-907-0400
Fax Number	:

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

Provider Enumeration Date	:	02/18/2007
Last Update Date	:	07/08/2007

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