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Organization
WESTERN RESERVE PROFESSIONAL GROUP INC
Active
Organization
WESTERN RESERVE PROFESSIONAL GROUP INC
Active
Other names
The Spine & Pain Institute
Organization subpart
No
Provider details
NPI number
Authorized official
RACHELLE ANN LIGHT (OFFICE COORDINATOR)
(330) 677-3628
Entity
Organization
Contact information
Practice address
307 WEST MAIN STREET, SUITE C, KENT, OH 44240-2400
(330) 677-3628
(330) 677-4931
Mailing address
PO BOX 715479, COLUMBUS, OH 43271-5479
(330) 677-3628
(330) 677-4931
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
—
NULL
111NX0800X
Orthopedic Chiropractor
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
Other
Enumeration date
05/24/2007
Last updated
01/15/2014
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