MEDICARE: NORTHWEST OHIO ORTHOPEDICS AND SPORTS MEDICINE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	878070	OTHER		CDC

General Provider Information

NPI Number	:	1124665856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST OHIO ORTHOPEDICS AND SPORTS MEDICINE, INC

Provider Business Mailing Address
First Line	:	7595 COUNTY ROAD 236
Second Line	:
City	:	FINDLAY
State	:	OH
Zip	:	45840-8738
Country	:	US
Telephone Number	:	419-427-3104
Fax Number	:

Provider Business Practice Location Address
First Line	:	15054 STATE ROUTE 224 E
Second Line	:
City	:	FINDLAY
State	:	OH
Zip	:	45840-9794
Country	:	US
Telephone Number	:	419-427-3030
Fax Number	:	419-427-3034

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	SHARON DAMON
Credential	:
Telephone Number	:	419-427-3104

Provider Enumeration Date	:	12/02/2019
Last Update Date	:	12/02/2019

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