Healthcare Provider Details

I. General information

NPI: 1538557970
Provider Name (Legal Business Name): DENISE GEORGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 E TURKEYFOOT LAKE RD
AKRON OH
44312-5242
US

IV. Provider business mailing address

3257 ROBINS TRCE
AKRON OH
44319-3885
US

V. Phone/Fax

Practice location:
  • Phone: 330-283-4645
  • Fax:
Mailing address:
  • Phone: 330-283-4645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZA2600X
TaxonomyMedical Art Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: