Most Relevant Information
Provider Data
| NPI Number: | 1003397654 |
| Provider Name: | ALEX JOHN POLENICK PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 50.005589RX |
Most Important Dates
| Enumeration Date: | 08/22/2018 |
| Last Updated: | 04/17/2024 |
Provider Practice Location
1499 BOARDMAN CANFIELD RD
BOARDMAN
OH
445124008
Practice Location Phone/Fax
| Phone: | 3307580577 |
| Fax: | 3305334587 |
Provider Mailing Location
8591 CROSSROADS DRIVE
YOUNGSTOWN
OH
44514
Provider Mailing Phone/Fax
| Phone: | 3307580577 |
| Fax: | 3307580466 |