| Organization Name: | CRYSTAL CLINIC ORTHOPAEDIC CENTER, LLC |
| NPI Number: | 1225313448 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONALD R SUNTKEN (PRESIDENT/CEO) |
| Mailing Address: | 323 High St Suite C Wadsworth |
| State: | OH US |
| Postal Code: | 442811869 |
| Phone Number: | 3303351586 |
| Fax Number: | 3303364236 |
| NPI Enumeration Date: | 10/19/2011 |
| NPI Last Update Date: | 05/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 284300000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Special Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical. |