Organization
OHIO INDEPENDENT COLLABORATIVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT KENT DO (CHAIRMAN)
(330) 929-2685
Entity
Organization
Contact information
Practice address
24651 CENTER RIDGE RD, SUITE 350, WESTLAKE, OH 44145-5635
(440) 895-5056
Mailing address
24651 CENTER RIDGE RD, SUITE 350, WESTLAKE, OH 44145-5635
(440) 895-5056
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/29/2016
Last updated
02/01/2016
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