Provider Demographics
NPI:1093800849
Name:RAGOZZINO, CARL ANTHONY JR (LCO)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:ANTHONY
Last Name:RAGOZZINO
Suffix:JR
Gender:M
Credentials:LCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 PINEHILL DR SW
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615-8945
Mailing Address - Country:US
Mailing Address - Phone:330-627-7720
Mailing Address - Fax:
Practice Address - Street 1:222 SCIO RD FRONT
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-8945
Practice Address - Country:US
Practice Address - Phone:330-627-4446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH010171744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management