Healthcare Provider Details

I. General information

NPI: 1831247675
Provider Name (Legal Business Name): ERIE OSTEOPATHIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 S MAIN ST
HURON OH
44839
US

IV. Provider business mailing address

808 S MAIN ST
HURON OH
44839
US

V. Phone/Fax

Practice location:
  • Phone: 419-433-6117
  • Fax: 419-433-7226
Mailing address:
  • Phone: 419-433-6117
  • Fax: 419-433-7226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MELISA L SCHUSTER
Title or Position: PRES
Credential: DO
Phone: 419-433-6117