| Dirty South Therapeutics Llc | |
|
2541 Hartwood Rd Chillicothe OH 45601-8136 | |
| (740) 993-9571 | |
| Not Available |
| Full Name | Dirty South Therapeutics Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2541 Hartwood Rd, Chillicothe, Ohio |
| Authorized Official Name and Position | Daniel Mathuews (OWNER) |
| Authorized Official Contact | 7409939571 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dirty South Therapeutics Llc 2541 Hartwood Rd Chillicothe OH 45601-8136 Ph: () - | Dirty South Therapeutics Llc 2541 Hartwood Rd Chillicothe OH 45601-8136 Ph: (740) 993-9571 |
| NPI Number | 1215711262 |
|---|---|
| Provider Enumeration Date | 08/22/2023 |
| Last Update Date | 08/22/2023 |
| Certification Date | 08/22/2023 |
| Medicare PECOS PAC ID | 4688020126 |
|---|---|
| Medicare Enrollment ID | O20231019002864 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215711262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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