MEDICARE: ILETA PIZANO PT, DPT

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	PT021893	OH

General Provider Information

NPI Number	:	1164313177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ILETA PIZANO PT, DPT

Provider Business Mailing Address
First Line	:	18400 HOPEWELL RD
Second Line	:
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-9512
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6640 PERIMETER DR
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-8030
Country	:	US
Telephone Number	:	380-240-9150
Fax Number	:

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

Provider Enumeration Date	:	07/09/2025
Last Update Date	:	07/09/2025

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