# PREMISE HEALTH OF OHIO MEDICAL, P.A

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BWXT NOG Wellness Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821458183
- **Authorized official:** DR. JON LEIZMAN MD (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 91 STIRLING AVE, BARBERTON, OH 44203-2615
- **Practice address phone:** (330) 861-7665
- **Practice address fax:** (330) 861-7731
- **Mailing address:** 5500 MARYLAND WAY, SUITE 400, BRENTWOOD, TN 37027-4948

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/01/2016
- **Last updated:** 08/16/2022