MEDICARE: ATOC PROFESSIONAL SERVICES

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
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1932924289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATOC PROFESSIONAL SERVICES

Provider Business Mailing Address
First Line	:	6005 FLEET AVENUE
Second Line	:	SUITE 102
City	:	CLEVELAND
State	:	OH
Zip	:	44105-3407
Country	:	US
Telephone Number	:	216-223-8723
Fax Number	:	844-325-0445

Provider Business Practice Location Address
First Line	:	6005 FLEET AVENUE
Second Line	:	SUITE 102
City	:	CLEVELAND
State	:	OH
Zip	:	44105-3407
Country	:	US
Telephone Number	:	216-223-8723
Fax Number	:	844-325-0445

Authorized Official
Title or Position	:	OWNER
Name	:	MS. WANYAH MAYFIELD
Credential	:
Telephone Number	:	216-223-8723

Provider Enumeration Date	:	11/21/2024
Last Update Date	:	11/21/2024

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Directions to “ATOC PROFESSIONAL SERVICES ” Practice Location

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