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Organization
AULTMAN CARROLLTON IMMEDIATE CARE
Active
Organization
AULTMAN CARROLLTON IMMEDIATE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAYVAAN MIR-MOHSEN MORTAZAVI MD (MD)
(330) 627-0091
Entity
Organization
Contact information
Practice address
1020 TRUMP RD NW, CARROLLTON, OH 44615-8422
(330) 627-0091
Mailing address
1020 TRUMP RD NW, CARROLLTON, OH 44615-8422
(330) 627-0091
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
35074895
OH
Other
Enumeration date
09/27/2006
Last updated
08/22/2020
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