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2051 W Central Ave Toledo OH 43606-3948 | |
| (419) 291-2051 | |
| (419) 479-6952 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2051 W Central Ave, Toledo, Ohio |
| Authorized Official Name and Position | Lori Mccune (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 4198247264 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2051 W Central Ave Toledo OH 43606-3948 Ph: (419) 291-2051 | 2051 W Central Ave Toledo OH 43606-3948 Ph: (419) 291-2051 |
| NPI Number | 1548525314 |
|---|---|
| Provider Enumeration Date | 07/09/2012 |
| Last Update Date | 07/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548525314 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Ohio) | Primary |
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