Organization
PREMIER INJURY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT SANTIAGO M.D. (PRESIDENT)
(614) 570-9659
Entity
Organization
Contact information
Practice address
1430 S HIGH ST, SUITE C, COLUMBUS, OH 43207-1045
(614) 444-5340
(614) 444-5342
Mailing address
247 GLEN VILLAGE CT, POWELL, OH 43065-9677
(614) 431-8869
(614) 431-9910
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
35057517
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0759362
—
OH
01
—
35057517
STATE MEDICLA LICENSE
OH
01
—
581025142-00
WORKERS' COMPENSATION
OH
Enumeration date
04/13/2016
Last updated
03/07/2023
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