| Great Trail Family Practice | |
|
1028 E Lincolnway Minerva OH 44657-1216 | |
| (330) 868-6044 | |
| (330) 868-6847 |
| Full Name | Great Trail Family Practice |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1028 E Lincolnway, Minerva, Ohio |
| Authorized Official Name and Position | Susan B Barr (OFFICE MANAGER) |
| Authorized Official Contact | 3308686044 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Trail Family Practice 1028 E Lincolnway Minerva OH 44657-1216 Ph: (330) 868-6044 | Great Trail Family Practice 1028 E Lincolnway Minerva OH 44657-1216 Ph: (330) 868-6044 |
| NPI Number | 1487713632 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 07/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487713632 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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