Organization
PHYT FOR FUNCTION CLEVELAND WEST
Active
Organization
PHYT FOR FUNCTION CLEVELAND WEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS SANDERS (OWNER)
(330) 718-6445
Entity
Organization
Contact information
Practice address
4435 W 220TH ST, FAIRVIEW PARK, OH 44126-3323
(216) 502-3246
Mailing address
3603 S SALEM WARREN RD, NORTH JACKSON, OH 44451-8713
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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