Prime Directives Pm&R LLC
Physical Medicine & Rehabilitation in Lakewood, OH. Organization (NPI-2).
NPI number1013666031
StatusActive
Last updated in NPPESMay 8, 2025
Details
- NPI
- 1013666031
- Entity type
- Organization (NPI-2)
- Legal business name
- Prime Directives Pm&R LLC
- Organization subpart
- No
- Enumeration date
- Mar 18, 2022
- Certification date
- May 8, 2025
- Last updated
- May 8, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | – | – | Yes |
Practice location
11800 Edgewater Dr Apt 715Lakewood, OH 44107-1755
Phone 440-345-9300
Mailing address
Po Box 660Mentor, OH 44061-0660
Authorized official
Nina Carmela R Tamayo
Ceo
7085251058
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