MEDICARE: STRATEGIC PLANNING GROUP

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	302F00000X	Exclusive Provider Organization

General Provider Information

NPI Number	:	1396091112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRATEGIC PLANNING GROUP

Provider Business Mailing Address
First Line	:	5142 RYAN RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2067
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5142 RYAN RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2067
Country	:	US
Telephone Number	:	567-868-2719
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DANA BLALARK
Credential	:
Telephone Number	:	567-868-2719

Provider Enumeration Date	:	07/30/2012
Last Update Date	:	07/30/2012

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