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General NPI Number Information
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NPI Number | 1891936191
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Entity Type | Organization
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Legal Business Name | THE HEART ATTACK AND STROKE PREVENTION INSTITUTE, LLC
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 03/16/2009
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Provider Practice Location Address
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Address Line | 4455 DRESSLER RD NW
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City | CANTON
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State | OH
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Zip | 44718-2785
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Country | US
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Telephone | 330-492-1420
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Fax | 330-492-1732
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Provider Business Mailing Address
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Address Line | 4455 DRESSLER RD NW
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City | CANTON
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State | OH
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Zip | 44718-2785
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Country | US
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Telephone | 330-492-1420
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Fax | 330-492-1732
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID J UTLAK
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Credential | M.D.
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Telephone | 330-492-7194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 35043878
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License Number State | OH
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