Healthcare Provider Details

I. General information

NPI: 1770540148
Provider Name (Legal Business Name): IKRON CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2347 VINE ST
CINCINNATI OH
45219-1745
US

IV. Provider business mailing address

2347 VINE ST
CINCINNATI OH
45219-1745
US

V. Phone/Fax

Practice location:
  • Phone: 513-621-1117
  • Fax: 513-621-2350
Mailing address:
  • Phone: 513-621-1117
  • Fax: 513-621-2350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number0317
License Number StateOH

VIII. Authorized Official

Name: MR. RANDY E STRUNK
Title or Position: EXECUTIVE DIRECTOR
Credential: MA, LPCC
Phone: 513-621-1117