Organization
PHYSICAL MEDICINE CENTER OF VAN WERT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOCELYN WRAY M.D. (PRESIDENT/OWNER)
(419) 232-6333
Entity
Organization
Contact information
Practice address
140 FOX RD, SUITE 303, VAN WERT, OH 45891-2496
(419) 232-6333
(419) 232-6444
Mailing address
140 FOX RD, SUITE 303, VAN WERT, OH 45891-2496
(419) 232-6333
(419) 232-6444
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
35-078836
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2879354
—
OH
01
—
DO8314
RAILROAD MEDICARE
OH
Enumeration date
11/15/2005
Last updated
12/13/2010
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