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General NPI Number Information
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NPI Number | 1558472654
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Entity Type | Organization
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Legal Business Name | QUICKCLINIC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4445 KENT RD
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City | STOW
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State | OH
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Zip | 44224-4332
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Country | US
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Telephone | 330-678-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 94 FOX TRACE LN
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City | HUDSON
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State | OH
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Zip | 44236-3469
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Country | US
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Telephone | 330-656-0956
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. RONALD BUCCI
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Credential | PHD
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Telephone | 330-665-0010
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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 | RN251833
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License Number State | OH
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