Individual
PAUL INNOCENZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
646 16TH ST, ASTORIA, OR 97103-3709
(503) 325-0313
Mailing address
7820 SUMMERSET DR, WALTON HILLS, OH 44146-4964
(440) 821-1270
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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