Organization
VAN WERT MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY KAY SUTTON (OFFICE MANAGER)
(419) 363-3008
Entity
Organization
Contact information
Practice address
506 S MAIN ST, ROCKFORD, OH 45882-9228
(419) 363-3008
(419) 363-2093
Mailing address
1250 S WASHINGTON ST, VAN WERT, OH 45891-2551
(419) 232-5279
(419) 238-0692
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
398291
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0349680
—
OH
05
—
2115259
—
OH
Enumeration date
02/15/2007
Last updated
03/29/2018
Update your record
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