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Organization
PLASTIC SURGERY INSTITUTE OF OHIO, LLC
Active
Organization
PLASTIC SURGERY INSTITUTE OF OHIO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED C STORCK DO (OWNER)
(216) 561-0133
Entity
Organization
Contact information
Practice address
28601 CHAGRIN BLVD STE 500, WOODMERE, OH 44122-4562
(216) 561-0312
(516) 561-0113
Mailing address
28601 CHAGRIN BLVD STE 500, WOODMERE, OH 44122-4562
(216) 561-0312
(516) 561-0113
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096001
—
OH
Enumeration date
08/20/2013
Last updated
01/17/2024
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