Healthcare Provider Details

I. General information

NPI: 1821817172
Provider Name (Legal Business Name): MR. ALBERT A FRAZIER SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2024
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3014 HARTMAN ST
TOLEDO OH
43608-1936
US

IV. Provider business mailing address

3014 HARTMAN ST
TOLEDO OH
43608-1936
US

V. Phone/Fax

Practice location:
  • Phone: 419-378-2768
  • Fax:
Mailing address:
  • Phone: 419-378-2768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: