Organization
PROMEDICA HEALTH SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY MOYER PA-C, RD, LD (PHYSICIAN ASSISTANT)
(419) 824-1785
Entity
Organization
Contact information
Practice address
5308 HARROUN RD STE 280, SYLVANIA, OH 43560-2190
(419) 824-1785
(419) 824-5953
Mailing address
157 N STATE ROUTE 510, FREMONT, OH 43420-9224
(419) 217-1614
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.004996RX
OH
Other
Enumeration date
02/10/2017
Last updated
02/10/2017
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