Provider Demographics
NPI:1326141805
Name:ZITO, DAVID ALLEN (LPT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALLEN
Last Name:ZITO
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1352 MATTHEWS TOWNSHIP PARKWAY
Mailing Address - Street 2:UNIT 102
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105
Mailing Address - Country:US
Mailing Address - Phone:704-847-6351
Mailing Address - Fax:704-849-2826
Practice Address - Street 1:1352 MATTHEWS TOWNSHIP PARKWAY
Practice Address - Street 2:UNIT 102
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105
Practice Address - Country:US
Practice Address - Phone:704-847-6351
Practice Address - Fax:704-849-2826
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPT 3848225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7207922Medicaid
NC07922OtherBCBC INDIVIDUAL
NC7207922Medicaid