Provider Demographics
NPI:1285302646
Name:ZELLERS, MICHAEL D (DPT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:ZELLERS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15765 STATE ROUTE 170 STE 2
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9600
Mailing Address - Country:US
Mailing Address - Phone:330-386-5252
Mailing Address - Fax:
Practice Address - Street 1:15765 STATE ROUTE 170 STE 2
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9600
Practice Address - Country:US
Practice Address - Phone:330-386-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT019481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist