Bristol Village Homes | |
621 E 5th St Waverly OH 45690-1505 | |
(740) 647-8670 | |
(740) 947-8680 |
Full Name | Bristol Village Homes |
---|---|
Speciality | Family Medicine |
Location | 621 E 5th St, Waverly, Ohio |
Authorized Official Name and Position | Jerry Kuyoth (VICE PRESIDENT) |
Authorized Official Contact | 6144512151 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Bristol Village Homes 621 E 5th St Waverly OH 45690-1505 Ph: (740) 647-8670 | Bristol Village Homes 621 E 5th St Waverly OH 45690-1505 Ph: (740) 647-8670 |
NPI Number | 1225248701 |
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Provider Enumeration Date | 05/23/2007 |
Last Update Date | 11/27/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225248701 | NPI | - | NPPES |
0213254 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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