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Organization

NORTHCOAST MEDICAL GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERESA LARSEN D.O. (OWNER)
(440) 785-5278
Entity
Organization

Contact information

Practice address
5325 SOM CENTER RD, SOLON, OH 44139-1459
(440) 785-5278
Mailing address
5325 SOM CENTER RD, SOLON, OH 44139-1459
(440) 785-5278

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
34-007383
OH

Other

Enumeration date
11/06/2012
Last updated
11/07/2012
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