Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2006-09-20
- Last updated
- 2008-04-14
Specialties
Licenses
- License OH
- 3504
Location
- Practice location
- 2633 STATE ROUTE 59, SUITE E
- City
- RAVENNA OH
- Postal code
- 442661684
- Phone
- 330-296-2829
Organization contact
- Name
- JOHN ALEXANDER
- Title
- owner
- Phone
- 3302962809
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.