Provider Demographics
NPI:1417169814
Name:PACIOREK, MARY RITA (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:RITA
Last Name:PACIOREK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:10902 BROOKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1102
Mailing Address - Country:US
Mailing Address - Phone:440-546-9094
Mailing Address - Fax:
Practice Address - Street 1:4630 RICHMOND RD
Practice Address - Street 2:SUITE 160
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5965
Practice Address - Country:US
Practice Address - Phone:216-514-7850
Practice Address - Fax:216-514-7853
Is Sole Proprietor?:No
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.006391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist