Organization
CENTERVILLE CLINICS, INC BLENDED BENTLEYVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTY MARTOS (DIRECTOR PERSONNEL AND FINANCE)
(724) 632-6801
Entity
Organization
Contact information
Practice address
100 WILSON RD, BENTLEYVILLE, PA 15314-1028
(724) 239-2390
Mailing address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007288440091
—
PA
Enumeration date
02/27/2008
Last updated
03/06/2008
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