Basic Information
| Provider Information | |||||||||
| NPI: | 1235582305 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHWEST OHIO ORTHOPEDICS AND SPORTS MEDICINE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7595 COUNTY ROAD 236 | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458408738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194271984 | ||||||||
| FaxNumber: | 4194272864 | ||||||||
| Practice Location | |||||||||
| Address1: | 15054 STATE ROUTE 224 E | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458409794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194273030 | ||||||||
| FaxNumber: | 4194273034 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2016 | ||||||||
| LastUpdateDate: | 11/08/2019 | ||||||||
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| AuthorizedOfficialLastName: | BOEHM | ||||||||
| AuthorizedOfficialFirstName: | MATT | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 4194273101 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NORTHWEST OHIO ORTHOPEDICS & SPORTS MEDICINE INC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 32-900011 | OH | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.