Provider Demographics
NPI:1184047128
Name:MICALI, JAMES THOMAS (PT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:THOMAS
Last Name:MICALI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7434 FAYETTE BLVD
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44215-9813
Mailing Address - Country:US
Mailing Address - Phone:330-807-6229
Mailing Address - Fax:330-745-5630
Practice Address - Street 1:500 W HOPOCAN AVE
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-2262
Practice Address - Country:US
Practice Address - Phone:330-615-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH32062251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic