Healthcare Provider Details

I. General information

NPI: 1003070459
Provider Name (Legal Business Name): WESTERN RESERVE O & P CENTRE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 07/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 SOUTH ARCH AVENUE
ALLIANCE OH
44601
US

IV. Provider business mailing address

2235 E. PERSHING STREET SUITE E
SALEM OH
44460
US

V. Phone/Fax

Practice location:
  • Phone: 330-821-1000
  • Fax: 330-821-1924
Mailing address:
  • Phone: 330-337-8333
  • Fax: 330-337-8373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: RICHARD L GROPE
Title or Position: OWNER/PRACTITIONER
Credential:
Phone: 330-792-6826