Healthcare Provider Details

I. General information

NPI: 1174087803
Provider Name (Legal Business Name): NORTHWEST OHIO ORTHOPEDICS AND SPORTS MEDICINE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 01/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 3RD AVE
FREMONT OH
43420-3269
US

IV. Provider business mailing address

7595 COUNTY ROAD 236
FINDLAY OH
45840-8738
US

V. Phone/Fax

Practice location:
  • Phone: 416-559-2790
  • Fax: 419-427-2864
Mailing address:
  • Phone: 419-427-3104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SHARON DAMON
Title or Position: BILLING MANAGER
Credential:
Phone: 419-427-3104