Provider Demographics
NPI:1568021442
Name:PRIMIANO, CAITLIN M (DPT)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:M
Last Name:PRIMIANO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:889 N AURORA RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-9537
Mailing Address - Country:US
Mailing Address - Phone:330-954-7177
Mailing Address - Fax:330-995-8279
Practice Address - Street 1:889 N AURORA RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-9537
Practice Address - Country:US
Practice Address - Phone:330-954-7177
Practice Address - Fax:330-995-8279
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDPT014704225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist