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Organization

PROMEDICA GENITO-URINARY SURGEONS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMY L DWYER (CREDENTIALING SUPERVISOR)
(419) 824-7334
Entity
Organization

Contact information

Practice address
970 W WOOSTER ST, SUITE 129, BOWLING GREEN, OH 43402-2643
(419) 353-1239
(419) 353-8364
Mailing address
970 W WOOSTER ST, SUITE 129, BOWLING GREEN, OH 43402-2643
(419) 353-1239
(419) 353-8364

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
OH

Other

Enumeration date
10/02/2013
Last updated
10/02/2013
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