Healthcare Provider Details

I. General information

NPI: 1134394265
Provider Name (Legal Business Name): KENT MANAGEMENT GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 HIGH ST SUITE 101
WADSWORTH OH
44281-1869
US

IV. Provider business mailing address

PO BOX 609
CUYAHOGA FALLS OH
44222-0609
US

V. Phone/Fax

Practice location:
  • Phone: 330-334-5265
  • Fax: 330-334-5006
Mailing address:
  • Phone: 330-923-6606
  • Fax: 330-923-8090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT A KENT
Title or Position: DO
Credential:
Phone: 330-929-2685