Organization
PEAUCHEE PASSION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA J MUNSEY (OWNER)
(740) 438-7515
Entity
Organization
Contact information
Practice address
121 SECOND ST, PLEASANTVILLE, OH 43148-0224
(740) 438-7515
Mailing address
PO BOX 224, 121 SECOND ST, PLEASANTVILLE, OH 43148-0224
(740) 438-7515
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
OH
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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