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3500 Executive Pkwy Toledo OH 43606-1319 | |
| (567) 585-5337 | |
| (567) 585-5336 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 3500 Executive Pkwy, Toledo, Ohio |
| Authorized Official Name and Position | Tanya Wines (DIRECTOR, CREDENTIALING) |
| Authorized Official Contact | 5675850422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
333 N Summit St Fl 7 Toledo OH 43604-1531 Ph: () - | 3500 Executive Pkwy Toledo OH 43606-1319 Ph: (567) 585-5337 |
| NPI Number | 1568001352 |
|---|---|
| Provider Enumeration Date | 12/27/2019 |
| Last Update Date | 03/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568001352 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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