Provider Demographics
NPI:1780711069
Name:DOLCEMASCHIO, JOSEPH RICHARD (LPT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:RICHARD
Last Name:DOLCEMASCHIO
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2318 WEST MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870
Mailing Address - Country:US
Mailing Address - Phone:330-801-3191
Mailing Address - Fax:
Practice Address - Street 1:4511 ROCKSIDE RD
Practice Address - Street 2:SUPPLEMENTAL HEALTHCARE SUITE 330
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131
Practice Address - Country:US
Practice Address - Phone:216-401-8638
Practice Address - Fax:216-901-0401
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH002956225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist