Provider Demographics
NPI:1699122242
Name:PM&R NORTH, INC.
Entity type:Organization
Organization Name:PM&R NORTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:ENGLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-758-8223
Mailing Address - Street 1:822 E WESTERN RESERVE RD
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-3359
Mailing Address - Country:US
Mailing Address - Phone:330-758-8223
Mailing Address - Fax:330-758-6993
Practice Address - Street 1:822 E WESTERN RESERVE RD
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-3359
Practice Address - Country:US
Practice Address - Phone:330-758-8223
Practice Address - Fax:330-758-6993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004675RX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty