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General NPI Number Information
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NPI Number | 1669702841
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Entity Type | Organization
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Legal Business Name | HANCHRIST, LLC
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Dates
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Enumeration Date | 01/11/2010
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 195 WADSWORTH RD SUITE 402
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City | WADSWORTH
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State | OH
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Zip | 44281
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Country | US
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Telephone | 330-331-7207
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Fax | 330-331-7587
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Provider Business Mailing Address
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Address Line | PO BOX 1243
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City | BATH
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State | OH
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Zip | 44210-1243
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Country | US
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Telephone | 330-331-7207
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Fax | 330-331-7587
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SAMANTHA L THESING
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Credential |
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Telephone | 330-331-7207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35067926
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License Number State | OH
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