Organization
LAKE HOSPITAL SYSTEM
Active
Other names
LHPG Thomas Mentor Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
RICK CICERO (SR. VP BUSINESS DEVELOPMENT)
(440) 354-1739
Entity
Organization
Contact information
Practice address
8316 YELLOWBRICK RD, MENTOR, OH 44060-4960
(440) 205-8818
(440) 974-1794
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(440) 205-8818
(440) 974-1794
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/17/2011
Last updated
08/17/2011
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