Healthcare Provider Details

I. General information

NPI: 1841661758
Provider Name (Legal Business Name): MINORIK HEALTH AND WELLNESS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 04/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 W MARKET ST
AKRON OH
44313-4204
US

IV. Provider business mailing address

2620 W MARKET ST
AKRON OH
44313-4204
US

V. Phone/Fax

Practice location:
  • Phone: 330-869-6566
  • Fax: 330-869-8066
Mailing address:
  • Phone: 330-869-6566
  • Fax: 330-869-8066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.007428
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY MINORIK
Title or Position: CEO
Credential: DC
Phone: 330-607-8464