Organization
MANAL H ASSAAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE TRUETT (OFFICE MANAGER)
(330) 433-0000
Entity
Organization
Contact information
Practice address
4360 FULTON DR NW, SUITE A, CANTON, OH 44718-2878
(330) 433-0000
Mailing address
4360 FULTON DR NW, SUITE A, CANTON, OH 44718-2878
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35074361
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2127559
—
OH
Enumeration date
01/14/2009
Last updated
06/19/2014
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