Organization
OPEN AWARENESS MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY W MCCLELLAND (OFFICE MANAGER)
(330) 339-9000
Entity
Organization
Contact information
Practice address
875 BLAKE AVE SW, SUITE #2, NEW PHILADELPHIA, OH 44663-9338
(330) 339-9000
(330) 339-1122
Mailing address
875 BLAKE AVE SW, SUITE #2, NEW PHILADELPHIA, OH 44663-9338
(330) 339-9000
(330) 339-1122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0340929
—
OH
Enumeration date
01/04/2010
Last updated
12/01/2010
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