Organization
PICKAWAY PROFESSIONAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH HOLTEN MD (MD/EXECUTIVE DIRECTOR)
(614) 552-0061
Entity
Organization
Contact information
Practice address
600 N PICKAWAY ST, CIRCLEVILLE, OH 43113-1447
(740) 474-2124
(614) 552-0068
Mailing address
PO BOX 71-4823, COLUMBUS, OH 43271-4823
(614) 552-0061
(614) 552-0168
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2347259
—
OH
Enumeration date
11/07/2006
Last updated
11/06/2012
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