Organization
WESTERN RESERVE PROFESSIONAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY SEMANCIK (ADMINISTRATIVE DIRECTOR)
(330) 677-3628
Entity
Organization
Contact information
Practice address
6847 N CHESTNUT ST, RAVENNA, OH 44266-3929
(330) 677-3628
(330) 677-3626
Mailing address
307 W MAIN ST, SUITE C, KENT, OH 44240-2400
(330) 677-3628
(330) 677-3626
Taxonomy
Speciality
Code
Description
License number
State
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
10/09/2006
Last updated
08/22/2020
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