Provider Demographics
NPI:1760867931
Name:FAMILY FERTILITYCARE CENTER
Entity Type:Organization
Organization Name:FAMILY FERTILITYCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESPONSIBLE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHOEN
Authorized Official - Suffix:
Authorized Official - Credentials:CFCE CFCP
Authorized Official - Phone:440-708-2566
Mailing Address - Street 1:10600 LELAND TR
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-6129
Mailing Address - Country:US
Mailing Address - Phone:440-708-2566
Mailing Address - Fax:
Practice Address - Street 1:10600 LELAND TR
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-6129
Practice Address - Country:US
Practice Address - Phone:440-708-2566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty