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
121 WESTFIELD DR, ARCHBOLD, OH 43502-1056
(537) 444-4748
(567) 444-4750
Mailing address
121 WESTFIELD DR, ARCHBOLD, OH 43502-1056
(537) 444-4748
(567) 444-4750
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
OH
Other
Enumeration date
05/24/2013
Last updated
05/24/2013
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