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General NPI Number Information
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NPI Number | 1871570622
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Entity Type | Organization
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Legal Business Name | ALLENSIDE FAMILY PRACTICE
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 01/11/2010
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Provider Practice Location Address
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Address Line | 2417 MANCHESTER RD
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City | AKRON
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State | OH
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Zip | 44314
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Country | US
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Telephone | 330-848-3377
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Fax | 330-848-3325
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Provider Business Mailing Address
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Address Line | 2417 MANCHESTER RD
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City | AKRON
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State | OH
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Zip | 44314
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Country | US
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Telephone | 330-848-3377
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Fax | 330-848-3325
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DEAN PATRICK RICH
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Credential | DO
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Telephone | 330-848-3377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34004672
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License Number State | OH
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