| NPI | 1174948418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY LEE PRUZINSKY Claims Processer 440-354-5643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: OH 34006748) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: OH 233) |
| 225100000X Physical Therapist (Licence: OH 012350) | |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2014-05-14 |