MEDICARE: HURON RECOVERY SPECIALISTS LLC

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	261Q00000X	Clinic/Center	35043120	OH

General Provider Information

NPI Number	:	1598209876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HURON RECOVERY SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	306 WILLIAMS ST
Second Line	:
City	:	HURON
State	:	OH
Zip	:	44839-1648
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	306 WILLIAMS ST
Second Line	:
City	:	HURON
State	:	OH
Zip	:	44839-1648
Country	:	US
Telephone Number	:	567-245-4576
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALAN L ROBBINS
Credential	:	M.D.
Telephone Number	:	567-245-4576

Provider Enumeration Date	:	12/06/2016
Last Update Date	:	12/06/2016

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