Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | S.0701547 | OH |
NPI | 1003117037 |
---|---|
Provider Name | Mr. Brian Christopher Perusek |
First Address | Akron, OH 44305-3838 |
Second Address | Akron, OH 44302-1801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2010 |
Last Update Date | 08/11/2010 |