Healthcare Provider Details

I. General information

NPI: 1962983528
Provider Name (Legal Business Name): CHRISTOPHER HEPLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 08/16/2022
Certification Date: 08/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 E PARK AVE
NILES OH
44446-2352
US

IV. Provider business mailing address

2380 STILLWAGON RD SE
WARREN OH
44484-3172
US

V. Phone/Fax

Practice location:
  • Phone: 330-544-8005
  • Fax: 330-544-9379
Mailing address:
  • Phone: 330-692-8843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: