| Western Reserve Professional Group | |
|
6847 N Chestnut St Ravenna OH 44266-3929 | |
| (330) 677-3628 | |
| (330) 677-3626 |
| Full Name | Western Reserve Professional Group |
|---|---|
| Speciality | Psychiatry & Neurology - Pain Medicine |
| Location | 6847 N Chestnut St, Ravenna, Ohio |
| Authorized Official Name and Position | Kelly Semancik (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 3306773628 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Reserve Professional Group 307 W Main St Suite C Kent OH 44240-2400 Ph: (330) 677-3628 | Western Reserve Professional Group 6847 N Chestnut St Ravenna OH 44266-3929 Ph: (330) 677-3628 |
| NPI Number | 1912094145 |
|---|---|
| Provider Enumeration Date | 10/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912094145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P2900X | Psychiatry & Neurology - Pain Medicine | (* (Not Available)) | Primary |
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