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Individual

MS. LAUREN ELIZABETH PERISA-CICCHILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
1553 NILES CORTLAND RD SE STE 1, WARREN, OH 44484-3073
(330) 372-2324
(330) 372-2309
Mailing address
1553 NILES CORTLAND RD SE STE 1, WARREN, OH 44484-3073
(330) 372-2324
(330) 372-2309

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT014947
OH
2251H1200X
Hand Physical Therapist
2251N0400X
Neurology Physical Therapist
2251S0007X
Sports Physical Therapist
2251X0800X
Orthopedic Physical Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0109240
OH
Enumeration date
08/07/2014
Last updated
12/08/2015
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