Most Relevant Information
Provider Data
| NPI Number: | 1003275801 |
| Provider Name: | ELSWORTH CHARLES BEACH DO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/22/2016 |
| Last Updated: | 08/02/2021 |
Provider Practice Location
2600 TUSCARAWAS ST W STE 600
CANTON
OH
447084676
Practice Location Phone/Fax
| Phone: | 3304534300 |
| Fax: |
Provider Mailing Location
1900 23RD ST
CUYAHOGA FALLS
OH
442231404
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |