Provider Demographics
NPI:1689365165
Name:REZAPOURIAN, SORIYA (PT, DPT)
Entity type:Individual
Prefix:
First Name:SORIYA
Middle Name:
Last Name:REZAPOURIAN
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 BIRCH TRACE DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-4901
Mailing Address - Country:US
Mailing Address - Phone:330-787-2264
Mailing Address - Fax:
Practice Address - Street 1:8591 CROSSROAD DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514-4382
Practice Address - Country:US
Practice Address - Phone:330-729-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT020383225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist