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825 S Cable Rd Unit A Lima OH 45805-3467 | |
(419) 224-1234 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 825 S Cable Rd Unit A, Lima, Ohio |
Authorized Official Name and Position | Brian Smith (VICE PRESIDENT) |
Authorized Official Contact | 4192273361 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 73471 Cleveland OH 44193-0002 Ph: (419) 224-1234 | 825 S Cable Rd Unit A Lima OH 45805-3467 Ph: (419) 224-1234 |
NPI Number | 1982802971 |
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Provider Enumeration Date | 07/11/2007 |
Last Update Date | 01/13/2022 |
Identifier | Type | State | Issuer |
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1982802971 | NPI | - | NPPES |
2677965 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | OH-58001642 (Ohio) | Primary |
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