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General NPI Number Information
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NPI Number | 1205062213
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Entity Type | Organization
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Legal Business Name | OHIO HEART ATTACK AND STROKE PREVENTION CENTER
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Dates
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Enumeration Date | 06/04/2009
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Last Update Date | 06/04/2009
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Provider Practice Location Address
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Address Line | 1320 CORPORATE DR 200
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City | HUDSON
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State | OH
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Zip | 44236-4442
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Country | US
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Telephone | 330-653-8020
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Fax | 330-342-5608
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Provider Business Mailing Address
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Address Line | 1320 CORPORATE DR 200
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City | HUDSON
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State | OH
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Zip | 44236-4442
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Country | US
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Telephone | 330-653-8020
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Fax | 330-342-5608
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEANETTE ANN MOLESKI
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Credential | D.O.
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Telephone | 330-653-8020
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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 | 34004256
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License Number State | OH
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