Individual
GARY SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
285 W STURBRIDGE DR, MEDINA, OH 44256-3889
(330) 783-5334
Mailing address
285 W STURBRIDGE DR, MEDINA, OH 44256-3889
(330) 783-5334
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
525135
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0141850
—
OH
Enumeration date
08/13/2015
Last updated
03/10/2016
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