Organization
UNIVERSITY PRIMARY CARE PRACTICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA KANACK (OFFICE MANAGER)
(216) 383-6480
Entity
Organization
Contact information
Practice address
1527 W 19TH ST, ASHTABULA, OH 44004-3033
(216) 383-0100
(216) 383-6481
Mailing address
PO BOX 74718, CLEVELAND, OH 44194-0801
(216) 383-6480
(216) 383-6745
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
02/27/2007
Last updated
08/22/2020
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