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General NPI Number Information
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NPI Number | 1942492822
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Entity Type | Organization
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Legal Business Name | MIRACLES UNLIMITED, INC.
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 880 E INDIANOLA AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44502-2370
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Country | US
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Telephone | 330-788-0588
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Fax |
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Provider Business Mailing Address
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Address Line | 880 E INDIANOLA AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44502-2370
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Country | US
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Telephone | 330-788-0588
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | TRACEY TATAR
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Credential |
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Telephone | 330-259-0784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT010918
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License Number State | OH
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