Healthcare Provider Details

I. General information

NPI: 1477689560
Provider Name (Legal Business Name): ROSEMARY FRANKS OTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4329 GREEN RD
HIGHLAND HILLS OH
44128-4884
US

IV. Provider business mailing address

34760 PARK EAST DR A103
SOLON OH
44139-4273
US

V. Phone/Fax

Practice location:
  • Phone: 216-464-0950
  • Fax:
Mailing address:
  • Phone: 440-248-6831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberOTA01778
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: