Healthcare Provider Details

I. General information

NPI: 1629592175
Provider Name (Legal Business Name): HEALTHY U ACADEMY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2017
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2484 W STATE ST
ALLIANCE OH
44601-5608
US

IV. Provider business mailing address

6384 HOLLYRIDGE ST NW
NORTH CANTON OH
44720-9402
US

V. Phone/Fax

Practice location:
  • Phone: 330-557-1086
  • Fax: 330-654-9086
Mailing address:
  • Phone: 330-802-2281
  • Fax: 330-654-9086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35077014G
License Number StateOH

VIII. Authorized Official

Name: KIM MYERS
Title or Position: OFFICE MANAGER
Credential:
Phone: 330-654-1181