| Knowlton Family Practice | |
|
1001 Pike St 7a Marietta OH 45750-3515 | |
| (740) 629-8528 | |
| Not Available |
| Full Name | Knowlton Family Practice |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1001 Pike St, Marietta, Ohio |
| Authorized Official Name and Position | Lesly Knowlton (NURSE PRACTITIONER) |
| Authorized Official Contact | 7406298528 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Knowlton Family Practice 1001 Pike St 7a Marietta OH 45750-3515 Ph: (740) 629-8528 | Knowlton Family Practice 1001 Pike St 7a Marietta OH 45750-3515 Ph: (740) 629-8528 |
| NPI Number | 1225410830 |
|---|---|
| Provider Enumeration Date | 06/19/2015 |
| Last Update Date | 06/19/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225410830 | NPI | - | NPPES |
| 2645310 | Medicaid | OH | |
| 3810011090 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | NP08402 (Ohio) | Primary |
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