# MEDETC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487953634
- **Authorized official:** LAURA JEAN WALDRON MD (PRESIDENT)
- **Authorized official phone:** (419) 303-3466

## Contact information

- **Practice address:** 2718 CAROLYN DR, LIMA, OH 45807-2310
- **Practice address phone:** (419) 302-3337
- **Mailing address:** 2718 CAROLYN DR, LIMA, OH 45807-2310
- **Mailing address phone:** (419) 302-3337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 35052128 | OH | Yes |

## Other

- **Enumeration date:** 03/26/2011
- **Last updated:** 03/26/2011