Organization
FREDERICKTOWN FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMANDA BOWERS (OFFICE MANAGER)
(740) 694-2110
Entity
Organization
Contact information
Practice address
16361 VILLAGE PKWY, FREDERICKTOWN, OH 43019-9585
(740) 694-2110
(740) 694-2127
Mailing address
16361 VILLAGE PKWY, FREDERICKTOWN, OH 43019-9585
(740) 694-2110
(740) 694-2127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2161191
—
OH
Enumeration date
02/15/2007
Last updated
07/20/2010
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