# ESR MEDICATION ASSISTED TREATMENT

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

## Provider details

- **NPI number:** 1255609822
- **Authorized official:** MR. RAUN D SKYRM (CREDENTIALING)
- **Authorized official phone:** (330) 773-3544

## Contact information

- **Practice address:** 405 TALLMADGE RD, CUYAHOGA FALLS, OH 44221-3362
- **Practice address phone:** (330) 773-3544
- **Practice address fax:** (330) 773-3698
- **Mailing address:** 405 TALLMADGE RD, CUYAHOGA FALLS, OH 44221-3362
- **Mailing address phone:** (330) 773-3544
- **Mailing address fax:** (330) 773-3698

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/09/2011
- **Last updated:** 12/09/2011