Organization Name: | PERRY COUNTY FAMILY PRACTICE, INC. |
NPI Number: | 1003088790 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THERESA L. ULRICH (PRACTICE MANAGER) |
Mailing Address: | 1625 Airport Rd New Lexington |
State: | OH US |
Postal Code: | 437649749 |
Phone Number: | 7403425158 |
Fax Number: | 7403427393 |
NPI Enumeration Date: | 04/02/2008 |
NPI Last Update Date: | 04/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 35-042516 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |