Healthcare Provider Details

I. General information

NPI: 1235465477
Provider Name (Legal Business Name): KENT MANAGEMENT GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2009
Last Update Date: 10/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 WADSWORTH RD SUITE G
WADSWORTH OH
44281-9504
US

IV. Provider business mailing address

999 N MAIN ST
AKRON OH
44310-1456
US

V. Phone/Fax

Practice location:
  • Phone: 330-929-2694
  • Fax: 330-929-2782
Mailing address:
  • Phone: 330-929-2694
  • Fax: 330-929-2782

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 JR.
Title or Position: AUTHORIZED OFFICIAL
Credential: DO
Phone: 330-929-2685