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General NPI Number Information
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NPI Number | 1326608126
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Entity Type | Organization
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Legal Business Name | E3 FITOLOGY, LLC
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Dates
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Enumeration Date | 06/14/2019
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 201 GREAT OAKS TRL
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City | WADSWORTH
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State | OH
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Zip | 44281-9430
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Country | US
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Telephone | 330-975-2974
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Fax |
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Provider Business Mailing Address
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Address Line | 1407 GLENOAK DR
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City | TALLMADGE
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State | OH
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Zip | 44278-2696
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Country | US
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Telephone | 623-680-2529
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID L BROWN
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Credential | DHSC
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Telephone | 623-680-2529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | 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 | 261QC1800X
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Taxonomy Name | Corporate Health 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 | 261QG0250X
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Taxonomy Name | Genetics Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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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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Taxonomy #6
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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