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General NPI Number Information
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NPI Number | 1164614343
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Entity Type | Organization
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Legal Business Name | FAMILY CHOICE HOUSE CALLS, LLC
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Dates
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Enumeration Date | 08/13/2007
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Last Update Date | 08/13/2007
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Provider Practice Location Address
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Address Line | 13881 STARLITE DR
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City | BROOK PARK
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State | OH
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Zip | 44142-3245
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Country | US
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Telephone | 216-898-0049
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Fax | 216-373-6609
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Provider Business Mailing Address
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Address Line | 13881 STARLITE DR
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City | BROOK PARK
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State | OH
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Zip | 44142-3245
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Country | US
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Telephone | 216-898-0049
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Fax | 216-373-6609
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | PAMELA M JONESPOST
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Credential | DO
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Telephone | 216-898-0049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34008337
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License Number State | OH
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