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General NPI Number Information
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NPI Number | 1538496922
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Entity Type | Organization
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Legal Business Name | S&S WEIGHT LOSS OPERATION
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Dates
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Enumeration Date | 11/05/2009
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Last Update Date | 11/05/2009
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Provider Practice Location Address
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Address Line | 2250 KRESGE DR
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City | AMHERST
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State | OH
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Zip | 44001-1245
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Country | US
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Telephone | 440-960-0474
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Fax | 440-960-0491
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Provider Business Mailing Address
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Address Line | 2250 KRESGE DR
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City | AMHERST
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State | OH
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Zip | 44001-1245
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Country | US
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Telephone | 440-960-0474
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Fax | 440-960-0491
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RONALD SANKER
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Credential | D.O
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Telephone | 440-960-0474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 132700000X
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Taxonomy Name | Dietary Manager
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License Number |
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License Number State |
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