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General NPI Number Information
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NPI Number | 1033135009
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Entity Type | Organization
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Legal Business Name | WOOSTER CLINIC, LLC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1740 CLEVELAND RD
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City | WOOSTER
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State | OH
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Zip | 44691-2204
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Country | US
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Telephone | 330-287-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 6801 BRECKSVILLE RD STE 20, ATTN: DPC RK2-7
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City | INDEPENDENCE
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State | OH
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Zip | 44131-5062
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VP CHIEF FINANCE OFFICER
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Name | DENNIS LARAWAY
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Credential |
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Telephone | 216-445-1343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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