Provider Demographics
NPI:1679523112
Name:SYNERGY PULMONARY SERVICES, LLC
Entity Type:Organization
Organization Name:SYNERGY PULMONARY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES/CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:PAVELZIK
Authorized Official - Suffix:
Authorized Official - Credentials:RCP,RRT,RPFT
Authorized Official - Phone:330-705-3318
Mailing Address - Street 1:3750 LOGAN AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-1541
Mailing Address - Country:US
Mailing Address - Phone:330-705-3318
Mailing Address - Fax:330-493-6675
Practice Address - Street 1:3750 LOGAN AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-1541
Practice Address - Country:US
Practice Address - Phone:330-705-3318
Practice Address - Fax:330-493-6675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33792279P1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary DiagnosticsGroup - Single Specialty