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Specialty details in registry · Bedford, OH

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At a glance

115 Grand Blvd, Bedford, OH 44146-2117

NPPES record updated Dec 1, 2025. Public records can lag behind changes at a practice.

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Practice location

115 Grand Blvd
Bedford, OH 44146-2117

Professional details: NPI, taxonomy & registry record

NPI1639031578

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 251E00000X
Enumeration date: Dec 1, 2025
Record updated: Dec 1, 2025

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

251E00000X · Primary

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

Practice location

115 Grand Blvd
Bedford, OH 44146-2117

Phone: (216) 385-1648

Mailing address

115 GRAND BLVD

BEDFORD, OH 441462117

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Information may be outdated or incomplete.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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