Provider Demographics
NPI:1619218435
Name:PIETTE, ERIC (LMT)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:PIETTE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24932 AURORA RD STE C
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-1790
Mailing Address - Country:US
Mailing Address - Phone:440-439-9440
Mailing Address - Fax:440-439-9447
Practice Address - Street 1:27700 EUCLID AVE # B
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3531
Practice Address - Country:US
Practice Address - Phone:216-289-2632
Practice Address - Fax:216-289-2654
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.019820225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist