Provider Demographics
NPI:1710292503
Name:BIOWAVE THERAPIES, LLC
Entity Type:Organization
Organization Name:BIOWAVE THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BLANC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-221-1219
Mailing Address - Street 1:3867 MEDINA RD
Mailing Address - Street 2:P.O. BOX 0194
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4506
Mailing Address - Country:US
Mailing Address - Phone:859-221-1219
Mailing Address - Fax:
Practice Address - Street 1:3867 MEDINA RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-4506
Practice Address - Country:US
Practice Address - Phone:859-221-1219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No261QA0900XAmbulatory Health Care FacilitiesClinic/CenterAmputee
No282N00000XHospitalsGeneral Acute Care Hospital
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities