Individual
KRISTIE LACIVITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8323 E MARKET ST, WARREN, OH 44484-2342
(330) 651-6824
Mailing address
7760 E LIBERTY ST, HUBBARD, OH 44425-9726
(330) 559-8787
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
014391
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014391
PT LICENSE NUMBER
OH
Enumeration date
03/28/2014
Last updated
03/28/2014
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