Provider Demographics
NPI:1497178610
Name:O'NEILL, ELYSE RAE (DPT)
Entity Type:Individual
Prefix:
First Name:ELYSE
Middle Name:RAE
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:1193 NORTON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-9526
Mailing Address - Country:US
Mailing Address - Phone:303-825-1152
Mailing Address - Fax:330-854-0829
Practice Address - Street 1:7452 FULTON DR NW STE A
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646
Practice Address - Country:US
Practice Address - Phone:330-880-4111
Practice Address - Fax:330-833-1817
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2023-11-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics