Organization Name: | SUPERIOR MED LLC |
NPI Number: | 1225080591 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CINDY HELLER (MEDICAL PRACTICE COORDINATOR) |
Mailing Address: | 1350 Clark St Cambridge |
State: | OH US |
Postal Code: | 437259614 |
Phone Number: | 7404390733 |
Fax Number: | 7404398996 |
NPI Enumeration Date: | 05/16/2006 |
NPI Last Update Date: | 09/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |