Organization
CENTER STREET COMMUNITY CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFF G EDWARDS (CEO)
(740) 375-6030
Entity
Organization
Contact information
Practice address
205 WEST CENTER STREET, SUITE 200, MARION, OH 43302-3700
(740) 375-6030
(740) 382-8291
Mailing address
205 WEST CENTER STREET, SUITE 200, MARION, OH 43302-3700
(740) 375-6030
(740) 382-8291
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2807734
—
OH
Enumeration date
07/05/2006
Last updated
04/16/2008
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