Organization
HEALTHSERVE PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C BOURLAND (PRESIDENT)
(614) 442-2431
Entity
Organization
Contact information
Practice address
445 ROCKY FORK BLVD, GAHANNA, OH 43230-3336
(614) 442-2431
(614) 442-2426
Mailing address
2939 KENNY RD STE 200, COLUMBUS, OH 43221-2406
(614) 274-5035
(440) 716-8608
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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