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Organization

COUNTY OF CLINTON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TERRY K HOLTEN M.D. (MEDICAL DIRECTOR)
(937) 382-7221
Entity
Organization

Contact information

Practice address
111 S NELSON AVE STE 1, WILMINGTON, OH 45177-2067
(937) 382-7221
(937) 382-7027
Mailing address
111 S NELSON AVE STE 1, WILMINGTON, OH 45177-2067
(937) 382-7221
(937) 382-7027

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0274439
OH
05
0566696
OH
Enumeration date
02/22/2007
Last updated
07/21/2022
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