Healthcare Provider Details

I. General information

NPI: 1174502512
Provider Name (Legal Business Name): PRN THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 NORTHWEST AVE STE. 104
TALLMADGE OH
44278-1850
US

IV. Provider business mailing address

PO BOX 6062
AKRON OH
44312-0062
US

V. Phone/Fax

Practice location:
  • Phone: 330-630-1860
  • Fax: 330-630-3198
Mailing address:
  • Phone: 330-630-1860
  • Fax: 330-630-3198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number02410
License Number StateOH

VIII. Authorized Official

Name: MR. RICHARD LEWIS HASH
Title or Position: PRESIDENT/CEO
Credential: P.T.
Phone: 330-630-1860