Provider Demographics
NPI:1316066939
Name:PSZNICK, KEVIN A (PT, RRT, CEAS)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:A
Last Name:PSZNICK
Suffix:
Gender:M
Credentials:PT, RRT, CEAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 NILES CORTLAND RD SE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2538
Mailing Address - Country:US
Mailing Address - Phone:330-399-4000
Mailing Address - Fax:330-399-4015
Practice Address - Street 1:953 NILES CORTLAND RD SE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2538
Practice Address - Country:US
Practice Address - Phone:330-399-4000
Practice Address - Fax:330-399-4015
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-8913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist