Provider Demographics
NPI:1871827923
Name:OBORN, JANEEN (LMT)
Entity Type:Individual
Prefix:
First Name:JANEEN
Middle Name:
Last Name:OBORN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 MANCHESTER RD
Mailing Address - Street 2:STE. R
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-1465
Mailing Address - Country:US
Mailing Address - Phone:330-715-1930
Mailing Address - Fax:330-882-3971
Practice Address - Street 1:3515 MANCHESTER RD
Practice Address - Street 2:STE. R
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-1465
Practice Address - Country:US
Practice Address - Phone:330-715-1930
Practice Address - Fax:330-882-3971
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH007601225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist