Provider Demographics
NPI:1437669132
Name:WAY, ROGER ANDERS
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:ANDERS
Last Name:WAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7998 ELM ST
Mailing Address - Street 2:
Mailing Address - City:GARRETTSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44231-1002
Mailing Address - Country:US
Mailing Address - Phone:330-977-7231
Mailing Address - Fax:
Practice Address - Street 1:7998 ELM ST
Practice Address - Street 2:
Practice Address - City:GARRETTSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44231-1002
Practice Address - Country:US
Practice Address - Phone:330-977-7231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-07
Last Update Date:2017-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child