Basic Information
| Provider Information | |||||||||
| NPI: | 1144827981 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PALAZZOLO | ||||||||
| FirstName: | AUSTIN | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 844 W NYE LN STE 102 | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897031571 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758834161 | ||||||||
| FaxNumber: | 7758832528 | ||||||||
| Practice Location | |||||||||
| Address1: | 60 PENNY LN | ||||||||
| Address2: | |||||||||
| City: | WATSONVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950763079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317869000 | ||||||||
| FaxNumber: | 8317869100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2020 | ||||||||
| LastUpdateDate: | 10/05/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 229218 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.