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Individual

MR. ANTHONY LOUIS DIBENEDETTO JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPO

Contact information

Practice address
8571 FOXWOOD COURT, SUITE C, POLAND, OH 44514
(330) 259-0265
(330) 259-0272
Mailing address
8571 FOXWOOD COURT, SUITE C, POLAND, OH 44514
(330) 259-0265
(330) 259-0272

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
LPO23
OH
224P00000X
Prosthetist
Primary
LPO23
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2347366
OH
Enumeration date
04/17/2006
Last updated
11/06/2007
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