Healthcare Provider Details

I. General information

NPI: 1124200613
Provider Name (Legal Business Name): AKRON GENERAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1587 BOETTLER RD SUITE 103
UNIONTOWN OH
44685-7823
US

IV. Provider business mailing address

400 WABASH AVE
AKRON OH
44307-2433
US

V. Phone/Fax

Practice location:
  • Phone: 330-896-9829
  • Fax:
Mailing address:
  • Phone: 330-896-9829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number751
License Number StateOH

VIII. Authorized Official

Name: MRS. PATRICIA A. DAVIS
Title or Position: PHYSICAL THERAPIST ASSISTANT
Credential: LPTA
Phone: 330-882-8179