Healthcare Provider Details

I. General information

NPI: 1790751584
Provider Name (Legal Business Name): ARTHUR ALAN MCCREARY MA. ED., A.T.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4125 MEDINA RD
AKRON OH
44333-2483
US

IV. Provider business mailing address

4125 MEDINA RD
AKRON OH
44333-2483
US

V. Phone/Fax

Practice location:
  • Phone: 330-665-8200
  • Fax: 330-665-8197
Mailing address:
  • Phone: 330-665-8200
  • Fax: 330-665-8197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT 000097
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: