Mt Victory Family Practice Llc | |
460 S Main St Mt Victory OH 43340 | |
(937) 354-2028 | |
(934) 354-2029 |
Full Name | Mt Victory Family Practice Llc |
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Speciality | Family Medicine |
Location | 460 S Main St, Mt Victory, Ohio |
Authorized Official Name and Position | Holly R Recob (PHYSICIAN) |
Authorized Official Contact | 9373542028 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mt Victory Family Practice Llc 460 S Main St Mt Victory OH 43340 Ph: (937) 354-2028 | Mt Victory Family Practice Llc 460 S Main St Mt Victory OH 43340 Ph: (937) 354-2028 |
NPI Number | 1245379494 |
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Provider Enumeration Date | 02/05/2007 |
Last Update Date | 06/20/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245379494 | NPI | - | NPPES |
0937795 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 34005413R (Ohio) | Primary |