| Wauseon Clinic Corp | |
|
495 S Shoop Ave Wauseon OH 43567-1719 | |
| (419) 335-7921 | |
| (419) 337-5988 |
| Full Name | Wauseon Clinic Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 495 S Shoop Ave, Wauseon, Ohio |
| Authorized Official Name and Position | Richard John Grieser (PRESIDENT) |
| Authorized Official Contact | 4193357921 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wauseon Clinic Corp Po Box 418 Wauseon OH 43567-0418 Ph: (419) 335-7921 | Wauseon Clinic Corp 495 S Shoop Ave Wauseon OH 43567-1719 Ph: (419) 335-7921 |
| NPI Number | 1992996524 |
|---|---|
| Provider Enumeration Date | 08/08/2007 |
| Last Update Date | 02/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992996524 | NPI | - | NPPES |
| 0646340 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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