Organization
PDI TOLEDO, LLC
Active
Organization
PDI TOLEDO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK CHAMPNEY CORNELL (AUTHORIZED OFFICIAL)
(440) 223-8848
Entity
Organization
Contact information
Practice address
10500 ANTENUCCI BLVD, SUITE 205, GARFIELD HEIGHTS, OH 44125
(216) 282-0923
Mailing address
10500 ANTENUCCI BLVD, SUITE 205, GARFIELD HEIGHTS, OH 44125
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261Q00000X
Clinic/Center
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Enumeration date
09/23/2022
Last updated
10/09/2023
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