Provider Demographics
NPI:1619386927
Name:IONNO, MICHELE GABRIELLO (DPT, MS)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:GABRIELLO
Last Name:IONNO
Suffix:
Gender:M
Credentials:DPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 DOVER ZOAR RD NE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-7938
Mailing Address - Country:US
Mailing Address - Phone:330-401-8321
Mailing Address - Fax:
Practice Address - Street 1:4324 DOVER ZOAR RD NE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-7938
Practice Address - Country:US
Practice Address - Phone:330-401-8321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21254225100000X
OHPT017843225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist