Basic Information
| Provider Information | |||||||||
| NPI: | 1598908485 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LABOR | ||||||||
| FirstName: | NICOLE | ||||||||
| MiddleName: | THERESA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 444 N MAIN ST | ||||||||
| Address2: | 6TH FLOOR | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443103110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303798190 | ||||||||
| FaxNumber: | 3303798191 | ||||||||
| Practice Location | |||||||||
| Address1: | 444 N MAIN ST | ||||||||
| Address2: | 6TH FLOOR | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443103110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303798190 | ||||||||
| FaxNumber: | 3303798191 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2009 | ||||||||
| LastUpdateDate: | 11/20/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 60 252295 | NY | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QA0401X | OS014921 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine | 207QA0401X | 34010211 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine |
No ID Information.