Healthcare Provider Details

I. General information

NPI: 1295918498
Provider Name (Legal Business Name): OCCUHEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 W CENTRAL AVE 3RD FLOOR
TOLEDO OH
43606-3846
US

IV. Provider business mailing address

2150 W CENTRAL AVE 3RD FLOOR
TOLEDO OH
43606-3846
US

V. Phone/Fax

Practice location:
  • Phone: 517-291-5517
  • Fax: 517-291-3263
Mailing address:
  • Phone: 517-291-5517
  • Fax: 517-291-3263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELE YOUNGDALE
Title or Position: DIRECTOR
Credential: RN
Phone: 517-291-5510