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General NPI Number Information
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NPI Number | 1942634829
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Entity Type | Organization
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Legal Business Name | DR. R.L. RAMBAUD AND ASSOCIATES, LLC
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Dates
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Enumeration Date | 08/27/2013
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 480 FRY RD
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City | WOOSTER
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State | OH
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Zip | 44691-9362
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Country | US
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Telephone | 330-316-6711
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 AUBURN PL NW
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City | CANTON
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State | OH
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Zip | 44703-1152
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Country | US
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Telephone | 330-316-6711
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROGER LEE RAMBAUD
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Credential | DMN
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Telephone | 330-316-6711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 13285
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License Number State | OH
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