# PHYSICIANS DIAGNOSTIC & REHABILITATION CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417058009
- **Authorized official:** MARIA IGNAZIO (OFFICE MANAGER)
- **Authorized official phone:** (330) 758-6440

## Contact information

- **Practice address:** 914 TRAILWOOD DR, BOARDMAN, OH 44512-5007
- **Practice address phone:** (330) 758-6440
- **Practice address fax:** (330) 758-6990
- **Mailing address:** 914 TRAILWOOD DR, BOARDMAN, OH 44512-5007
- **Mailing address phone:** (330) 758-6440
- **Mailing address fax:** (330) 758-6990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 2426 | OH | — |
| 111N00000X | Chiropractor | 2533 | OH | Yes |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | 34.002093 | OH | — |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 01/26/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2318030 | — | OH |