| Provectus Ltc Llc | |
|
300 W Spring St Unit 702 Columbus OH 43215-7651 | |
| (937) 402-1000 | |
| Not Available |
| Full Name | Provectus Ltc Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 300 W Spring St Unit 702, Columbus, Ohio |
| Authorized Official Name and Position | Dirk N Juschka (MD) |
| Authorized Official Contact | 9374021000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provectus Ltc Llc Po Box 609 Lucasville OH 45648-0609 Ph: (937) 402-1000 | Provectus Ltc Llc 300 W Spring St Unit 702 Columbus OH 43215-7651 Ph: (937) 402-1000 |
| NPI Number | 1942973367 |
|---|---|
| Provider Enumeration Date | 07/30/2021 |
| Last Update Date | 07/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942973367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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