Organization
LIFESTREAM
Active
Other names
Harbor
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SHEEHAN (PRESIDENT)
(419) 475-4449
Entity
Organization
Contact information
Practice address
6629 W CENTRAL AVE, TOLEDO, OH 43617-1098
(419) 475-4449
Mailing address
P.O. BOX 8970, TOLEDO, OH 43623
(419) 475-4449
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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