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General NPI Number Information
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NPI Number | 1205281581
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Entity Type | Organization
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Legal Business Name | PRO HEALTH SERVICES LLC
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Dates
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Enumeration Date | 04/25/2016
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 2975 DONNYLANE BLVD
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City | COLUMBUS
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State | OH
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Zip | 43235-3228
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Country | US
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Telephone | 614-442-2600
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Fax | 614-442-1600
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Provider Business Mailing Address
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Address Line | 2975 DONNYLANE BLVD
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City | COLUMBUS
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State | OH
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Zip | 43235-3228
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Country | US
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Telephone | 614-442-2600
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Fax | 614-442-1600
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANGELICE ALEXANDER
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Credential | MD
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Telephone | 614-442-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 35080261
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License Number State | OH
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