Healthcare Provider Details

I. General information

NPI: 1184041626
Provider Name (Legal Business Name): OHIO NATUROPATHIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2014
Last Update Date: 03/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 BOARDMAN CANFIELD RD SUITE D3
BOARDMAN OH
44512-4300
US

IV. Provider business mailing address

755 BOARDMAN CANFIELD RD SUITE D3
BOARDMAN OH
44512-4300
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-1350
  • Fax:
Mailing address:
  • Phone: 330-729-1350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number099-0000113
License Number StateVT

VIII. Authorized Official

Name: DR. TED SUZELIS
Title or Position: OWNER
Credential: ND
Phone: 330-729-1350