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General NPI Number Information
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NPI Number | 1053987446
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Entity Type | Organization
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Legal Business Name | ALS MOUNT VERNON INC
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Dates
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Enumeration Date | 05/27/2021
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 1135 GAMBIER RD
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City | MOUNT VERNON
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State | OH
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Zip | 43050-3839
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Country | US
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Telephone | 740-415-1138
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Fax |
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Provider Business Mailing Address
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Address Line | 26261 MAIN ST
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City | COOLVILLE
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State | OH
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Zip | 45723-9204
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Country | US
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Telephone | 740-350-9095
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Fax |
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | JEFF DEGYANSKY
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Credential |
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Telephone | 330-620-7828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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