Provider Demographics
NPI:1871184275
Name:MOBILE MED
Entity type:Organization
Organization Name:MOBILE MED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CANTZLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-551-8846
Mailing Address - Street 1:6770 HAYHURST ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2539
Mailing Address - Country:US
Mailing Address - Phone:614-327-2755
Mailing Address - Fax:
Practice Address - Street 1:597 HIGH ST UNIT 101
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-5003
Practice Address - Country:US
Practice Address - Phone:614-551-8846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care