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NPI Code Detail

MEDICARE: PHILLIP M SPECK QMHS

MEDICARE: PHILLIP M SPECK QMHS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1164917753
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP M SPECK QMHS
Provider Business Mailing Address
First Line : 1500 RUTH AVE
Second Line :
City : CUYAHOGA FALLS
State : OH
Zip : 44221-2940
Country : US
Telephone Number : 330-883-4894
Fax Number :
Provider Business Practice Location Address
First Line : 9500 DETROIT AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-1852
Country : US
Telephone Number : 216-283-4400
Fax Number : 216-283-5359
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2018
Last Update Date : 06/26/2018

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Directions to “ PHILLIP M SPECK QMHS” Practice Location

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