| |
305 Upper River Rd, Ste 2, Gallipolis, OH 45631-8020 | |
(740) 446-4421 | |
(740) 446-4553 |
Full Name | |
---|---|
Type | Facility |
Speciality | Family Medicine |
Location | 305 Upper River Rd, Gallipolis, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700898509 | NPI | - | NPPES |
0682917 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 1336 (Ohio) | Secondary |
207Q00000X | Family Medicine | 34007332 (Ohio) | Primary |
Mailing Address | Practice Location Address |
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305 Upper River Rd, Ste 2, Gallipolis, OH 45631-8020 Ph: (740) 446-4421 | 305 Upper River Rd, Ste 2, Gallipolis, OH 45631-8020 Ph: (740) 446-4421 |