Organization
DIANA BREWSTER, D.O., LLC
Active
Other names
Brewster Family Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANA BREWSTER D.O. (OWNER)
(330) 433-9260
Entity
Organization
Contact information
Practice address
4124 FULTON DR NW, STE 101, CANTON, OH 44718-2852
(330) 433-9260
(330) 433-9263
Mailing address
4124 FULTON DR NW, STE 101, CANTON, OH 44718-2852
(330) 433-9260
(330) 433-9263
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34007790
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2399855
—
OH
Enumeration date
10/01/2014
Last updated
10/01/2014
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