Provider Demographics
NPI:1144299058
Name:PANOS, JOHN N (ATC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:N
Last Name:PANOS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 FIELD CLUB RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2406
Mailing Address - Country:US
Mailing Address - Phone:412-967-4407
Mailing Address - Fax:412-967-2415
Practice Address - Street 1:611 FIELD CLUB RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2406
Practice Address - Country:US
Practice Address - Phone:412-967-4407
Practice Address - Fax:412-967-2415
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART00018652255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer