Individual
AUSTIN MINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2049 E 100TH ST, CLEVELAND, OH 44106-2104
(216) 444-6126
Mailing address
1495 WHITE ASH DR, PAINESVILLE, OH 44077-5468
(440) 227-7179
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.007220RX
OH
Other
Enumeration date
10/10/2021
Last updated
10/10/2021
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