Provider Demographics
NPI:1821534413
Name:ECK, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-1533
Mailing Address - Country:US
Mailing Address - Phone:330-801-1405
Mailing Address - Fax:
Practice Address - Street 1:163 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-1533
Practice Address - Country:US
Practice Address - Phone:330-801-1405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-06
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0182779Medicaid