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General NPI Number Information
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NPI Number | 1316535974
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Entity Type | Organization
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Legal Business Name | 1419 ARLINGTON MEDICAL LLC
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 01/08/2021
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Provider Practice Location Address
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Address Line | 1419 S ARLINGTON ST
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City | AKRON
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State | OH
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Zip | 44306
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Country | US
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Telephone | 330-773-3882
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Fax |
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Provider Business Mailing Address
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Address Line | 1712 PIONEER AVE STE 500
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City | CHEYENNE
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State | WY
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Zip | 82001
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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 | REPRESENTATTIVE
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Name | REBECCA MURRAY
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Credential |
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Telephone | 615-613-3871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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