Healthcare Provider Details
I. General information
NPI: 1033374764
Provider Name (Legal Business Name): CONCENTRA AKRON L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2008
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1450 FIRESTONE PARKWAY SUITE F
AKRON OH
44301
US
IV. Provider business mailing address
5080 SPECTRUM DRIVE SUITE 1200 WEST
ADDISON TX
75001-4625
US
V. Phone/Fax
- Phone: 330-724-3345
- Fax: 330-724-5299
- Phone: 800-232-3550
- Fax: 972-387-8058
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KEITH
NEWTON
Title or Position: PRESIDENT
Credential: MD
Phone: 972-364-8000