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Specialty details in registry · Toledo, OH

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At a glance

757 Prouty Ave, Toledo, OH 43609-3331

NPPES record updated May 9, 2023. Public records can lag behind changes at a practice.

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Practice location

757 Prouty Ave
Toledo, OH 43609-3331

Professional details: NPI, taxonomy & registry record

NPI1033809447

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 324500000X
Enumeration date: May 9, 2023
Record updated: May 9, 2023

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

101YA0400X

Specialty details in registry

251B00000X

Specialty details in registry

261QR0800X

Specialty details in registry

324500000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

757 Prouty Ave
Toledo, OH 43609-3331

Phone: (419) 215-4131

Mailing address

757 PROUTY AVE

TOLEDO, OH 436093331

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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