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Organization

KNOWLTON FAMILY PRACTICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LESLY KNOWLTON NP (NURSE PRACTITIONER)
(740) 629-8528
Entity
Organization

Contact information

Practice address
1001 PIKE ST, 7A, MARIETTA, OH 45750-3515
(740) 629-8528
Mailing address
1001 PIKE ST, 7A, MARIETTA, OH 45750-3515
(740) 629-8528

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
NP08402
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2645310
OH
05
3810011090
OH
Enumeration date
06/19/2015
Last updated
06/19/2015
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