Organization
MEDETC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA JEAN WALDRON MD (PRESIDENT)
(419) 303-3466
Entity
Organization
Contact information
Practice address
2718 CAROLYN DR, LIMA, OH 45807-2310
(419) 302-3337
Mailing address
2718 CAROLYN DR, LIMA, OH 45807-2310
(419) 302-3337
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35052128
OH
Other
Enumeration date
03/26/2011
Last updated
03/26/2011
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