| Organization Name: | DEMER RETAIL VENTURES MH, LLC |
| NPI Number: | 1225446321 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID ADRIAN DEMER (PRESIDENT) |
| Mailing Address: | 3505 Westgate D416 Fairview Park |
| State: | OH US |
| Postal Code: | 441261331 |
| Phone Number: | 4409738627 |
| Fax Number: | |
| NPI Enumeration Date: | 08/01/2014 |
| NPI Last Update Date: | 08/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP3300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Pain |
| Taxonomy Definition: | |