Provider Demographics
NPI:1447240940
Name:CALZOLA, VINCENT P (PT)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:P
Last Name:CALZOLA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7442 FRANK AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-7022
Mailing Address - Country:US
Mailing Address - Phone:330-305-0838
Mailing Address - Fax:330-455-6114
Practice Address - Street 1:7442 FRANK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7022
Practice Address - Country:US
Practice Address - Phone:330-305-0838
Practice Address - Fax:330-455-6114
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT07988225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPT07988OtherOT PT ATC BOARD
OH2623478Medicaid
OHPT07988OtherOT PT ATC BOARD