Organization
WESTERN STARK MEDICAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE DANIELS MSS,MAC,LSW,EVCIII (CEO)
(330) 834-1546
Entity
Organization
Contact information
Practice address
820 AMHERST RD NE, MASSILLON, OH 44646-8525
(330) 834-1546
(330) 834-1548
Mailing address
820 AMHERST RD NE, MASSILLON, OH 44646-8525
(330) 834-1546
(330) 834-1548
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
194
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2369726
—
OH
Enumeration date
02/12/2007
Last updated
08/22/2020
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