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Organization
WESTERN RESERVE PROFESSIONAL GROUP INC
Active
Organization
WESTERN RESERVE PROFESSIONAL GROUP INC
Active
Other names
OCC MED SOURCE
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ANN SEMANCIK (ADMINISTRATIVE DIRECTOR)
(330) 548-0080
Entity
Organization
Contact information
Practice address
174 CURRIE HALL PKWY, STE D, KENT, OH 44240-4387
(330) 548-0086
(330) 548-0085
Mailing address
PO BOX 951971, CLEVELAND, OH 44193-0021
(330) 548-0080
(330) 548-0085
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
05/01/2006
Last updated
08/22/2020
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