Basic Information
| Provider Information | |||||||||
| NPI: | 1982257622 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HELD | ||||||||
| FirstName: | CARLI | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2852 SHILLINGFORD CIR NW | ||||||||
| Address2: | |||||||||
| City: | NORTH CANTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 447208228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304151933 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5760 PATRIOT BLVD | ||||||||
| Address2: | |||||||||
| City: | AUSTINTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445151170 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3309530243 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2019 | ||||||||
| LastUpdateDate: | 07/22/2019 | ||||||||
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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 | 363A00000X | 50.005941RX | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.