| Regenerative Medicine Of Ohio Llc | |
|
9257 W Sprague Rd North Royalton OH 44133-1208 | |
| (440) 884-0083 | |
| (440) 884-6864 |
| Full Name | Regenerative Medicine Of Ohio Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 9257 W Sprague Rd, North Royalton, Ohio |
| Authorized Official Name and Position | Patrick J Mccluskey (STATUTORY AGENT) |
| Authorized Official Contact | 4408840083 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regenerative Medicine Of Ohio Llc 9257 W Sprague Rd North Royalton OH 44133-1208 Ph: (440) 884-0083 | Regenerative Medicine Of Ohio Llc 9257 W Sprague Rd North Royalton OH 44133-1208 Ph: (440) 884-0083 |
| NPI Number | 1710464912 |
|---|---|
| Provider Enumeration Date | 07/20/2018 |
| Last Update Date | 07/20/2018 |
| Medicare PECOS PAC ID | 4082038997 |
|---|---|
| Medicare Enrollment ID | O20200724002415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710464912 | NPI | - | NPPES |
| 35.050134 | Other | OH | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | 35.050134 (Ohio) | Primary |
| Provider Name | Janette L Vodhanel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811996630 PECOS PAC ID: 2466407069 Enrollment ID: I20050316000856 |
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