Organization
TUSCARAWAS OPEN MRI LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY TROTT THEODOSOPOULOS (ADMINISTRATOR)
(330) 365-2101
Entity
Organization
Contact information
Practice address
340 OXFORD STREET, SUITE 30, DOVER, OH 44622
(330) 364-9966
(330) 364-5134
Mailing address
340 OXFORD STREET, SUITE 30, DOVER, OH 44622
(330) 364-9966
(330) 364-5134
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10961C
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2555417
—
OH
Enumeration date
05/17/2006
Last updated
04/24/2008
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