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Organization

PHYSICIANS DIAGNOSTIC & REHABILITATION CENTER OF WARREN IN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEITH P FARRELL D.C. (OWNER)
(330) 372-5550
Entity
Organization

Contact information

Practice address
2048 N RIVER RD NE # 3, WARREN, OH 44483-2530
(330) 372-5550
(330) 372-5551
Mailing address
PO BOX 14465, POLAND, OH 44514-7465
(330) 372-5550
(330) 372-5551

Taxonomy

Speciality
Code
Description
License number
State
111NR0200X
Radiology Chiropractor
3569
OH
208100000X
Physical Medicine & Rehabilitation Physician
Primary
34.002093
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2459307
OH
Enumeration date
09/26/2006
Last updated
11/19/2012
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