Healthcare Provider Details

I. General information

NPI: 1508008970
Provider Name (Legal Business Name): FELICIA KAREN PUREFOY MEDICAL ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 04/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 WEST BURNS AVE
AKRON OH
44310
US

IV. Provider business mailing address

25 W BURNS AVE
AKRON OH
44310-1306
US

V. Phone/Fax

Practice location:
  • Phone: 330-928-9912
  • Fax:
Mailing address:
  • Phone: 330-928-9912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: