Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 34.013230 | OH |
NPI | 1225490501 |
---|---|
Provider Name | Zachary Vallandingham |
First Address | Akron, OH 44320-4226 |
Second Address | Akron, OH 44320-4226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2016 |
Last Update Date | 05/08/2020 |