Provider Demographics
NPI:1487216487
Name:DEMETRO, ARIEL (PT, DPT, MS)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:DEMETRO
Suffix:
Gender:F
Credentials:PT, DPT, MS
Other - Prefix:
Other - First Name:ARIEL
Other - Middle Name:
Other - Last Name:KLINGAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, MS
Mailing Address - Street 1:1320 MERCY DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-2614
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1320 MERCY DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2614
Practice Address - Country:US
Practice Address - Phone:330-489-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
OHPT016431225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist