Healthcare Provider Details

I. General information

NPI: 1538599923
Provider Name (Legal Business Name): SHERI HUFNAGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2013
Last Update Date: 11/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 E MAPLE ST
NORTH CANTON OH
44720-2593
US

IV. Provider business mailing address

634 PURDUE AVE
AUSTINTOWN OH
44515-4214
US

V. Phone/Fax

Practice location:
  • Phone: 330-498-8239
  • Fax:
Mailing address:
  • Phone: 330-881-6672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number07258
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: