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General NPI Number Information
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NPI Number | 1831640390
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Entity Type | Organization
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Legal Business Name | CONCORDIA OF OHIO
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 03/03/2017
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Provider Practice Location Address
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Address Line | 970 SUMNER PKWY
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City | COPLEY
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State | OH
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Zip | 44321-1693
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Country | US
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Telephone | 330-664-1000
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Fax | 330-664-1197
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Provider Business Mailing Address
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Address Line | 970 SUMNER PKWY
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City | COPLEY
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State | OH
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Zip | 44321-1693
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Country | US
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Telephone | 330-664-1000
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Fax | 330-664-1197
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Authorized Official
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Title or Position | CEO
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Name | CHARLENE KISH
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Credential |
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Telephone | 330-664-1360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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