Provider Demographics
NPI:1174564207
Name:COLETTO, THOMAS ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ANTHONY
Last Name:COLETTO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 CORPORATE WAY
Mailing Address - Street 2:SUITE850
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1537
Mailing Address - Country:US
Mailing Address - Phone:440-871-4700
Mailing Address - Fax:440-871-4702
Practice Address - Street 1:2750 DOVER CENTER RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-4501
Practice Address - Country:US
Practice Address - Phone:440-808-9840
Practice Address - Fax:440-808-9862
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2842111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH350052055OtherMEDICARE RAILROAD PIN
OH350052055OtherMEDICARE RAILROAD PIN
OH4011711Medicare PIN