Provider Demographics
NPI:1164655775
Name:ZOTTO-YZNAGA, FAITH E (LPTA)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:E
Last Name:ZOTTO-YZNAGA
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 STONEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-3128
Mailing Address - Country:US
Mailing Address - Phone:440-243-4775
Mailing Address - Fax:440-243-4775
Practice Address - Street 1:602 TOURNAMENT DR
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-2284
Practice Address - Country:US
Practice Address - Phone:440-221-0444
Practice Address - Fax:440-933-6855
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-30
Last Update Date:2009-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06184225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant