Portage Family Practice Clinic, Inc.

NPI 1083767677 - Clinic/Center - 261Q00000X

NPI Details
NPI 1083767677
Enumeration Date 01/19/2007
Last Updated 10/25/2011
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name LEONARD D LEONARD
Position PRESIDENT
Phone (330) 499-7591
Fax (330) 499-0308
Practice Location
1413 PORTAGE ST NW
NORTH CANTON OH, 44720-2288, US
Phone (330) 499-7591
Fax (330) 499-0308
Business Location
1413 PORTAGE ST NW
NORTH CANTON OH, 44720-2288, US
Phone (330) 499-7591
Fax (330) 499-0308
Toxanomy
Taxonomy Code 261Q00000X
License State Ohio
License Number 34003002
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According to our database, Portage Family Practice Clinic, Inc. NPI is 1083767677, taxonomy code is 261Q00000X and license number is 34003002, license state is located at Ohio. Portage Family Practice Clinic, Inc. physically located at 1413 Portage St Nw, North Canton OH, 44720-2288. NPI Number 1033115704 has the healthcare provider type.

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1083767677 NPI number is provided on an as is basis without warranty of any kind. 1083767677 is maintained by the National Plan & Provider Enumeration System. The contents of Portage Family Practice Clinic, Inc. are for informational purposes only.