Provider Demographics
NPI:1639307630
Name:PARMATOWN PHYSICAL THERAPY
Entity Type:Organization
Organization Name:PARMATOWN PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:FORTUNA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-888-4526
Mailing Address - Street 1:6900 RIDGE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5650
Mailing Address - Country:US
Mailing Address - Phone:440-888-4526
Mailing Address - Fax:440-888-9102
Practice Address - Street 1:6900 RIDGE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5650
Practice Address - Country:US
Practice Address - Phone:440-888-4526
Practice Address - Fax:440-888-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT006007261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center