Provider Demographics
NPI:1932655065
Name:METABOLIC WEIGHT LOSS CLINIC LLC
Entity Type:Organization
Organization Name:METABOLIC WEIGHT LOSS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:567-278-1809
Mailing Address - Street 1:1433 E SANDUSKY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-6456
Mailing Address - Country:US
Mailing Address - Phone:419-423-6879
Mailing Address - Fax:419-423-6983
Practice Address - Street 1:1433 E SANDUSKY ST
Practice Address - Street 2:SUITE A
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-6456
Practice Address - Country:US
Practice Address - Phone:419-423-6879
Practice Address - Fax:419-423-6983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064459207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty