Organization
PROMEDICA CENTRAL PHYSICIANS, LLC
Active
Other names
Northwest Ohio ENT Consultants
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY GOVAN (CREDENTIALING SUPERVISOR)
(419) 824-7221
Entity
Organization
Contact information
Practice address
1200 RALSTON AVE, DEFIANCE, OH 43512-1396
(419) 783-6847
(419) 782-7580
Mailing address
1200 RALSTON AVE, DEFIANCE, OH 43512-1396
(419) 783-6847
(419) 782-7580
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35.078360
OH
Other
Enumeration date
09/12/2007
Last updated
02/18/2008
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