# BRUNSWICK FAMILY MEDICINE, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194901066
- **Authorized official:** ALLIE WUKOVICH CPC (PRACTICE MANAGER)
- **Authorized official phone:** (330) 558-0405

## Contact information

- **Practice address:** 3919 CENTER RD, BRUNSWICK, OH 44212-3087
- **Practice address phone:** (330) 558-0405
- **Practice address fax:** (330) 558-0421
- **Mailing address:** 3919 CENTER RD, BRUNSWICK, OH 44212-3087
- **Mailing address phone:** (330) 558-0405
- **Mailing address fax:** (330) 558-0421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 34007490 | OH | Yes |

## Other

- **Enumeration date:** 01/10/2008
- **Last updated:** 07/09/2013