Healthcare Provider Details

I. General information

NPI: 1295015634
Provider Name (Legal Business Name): HEALTHY LIFE SCREENING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 N. CLEVELAND-MASSILLON RD SUITE E
AKRON OH
44333-4557
US

IV. Provider business mailing address

61 N. CLEVELAND-MASSILLON RD SUITE E
AKRON OH
44333-4557
US

V. Phone/Fax

Practice location:
  • Phone: 330-670-0200
  • Fax: 330-670-0397
Mailing address:
  • Phone: 330-670-0200
  • Fax: 330-670-0397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name: BARRY EASTERLING
Title or Position: PRESIDENT & CEO
Credential:
Phone: 330-670-0200