Organization
PERRY COUNTY FAMILY PRACTICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA L ULRICH MSW, LISW (OWNER/SOCIAL WORKER)
(740) 342-5158
Entity
Organization
Contact information
Practice address
1625 AIRPORT RD, NEW LEXINGTON, OH 43764-9749
(740) 342-5158
(740) 342-7393
Mailing address
1625 AIRPORT RD, NEW LEXINGTON, OH 43764-9749
(740) 342-5158
(740) 342-7393
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
35-042516
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0648580
—
OH
05
—
0940996
—
OH
Enumeration date
08/05/2006
Last updated
03/28/2008
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