Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2011-06-03
- Last updated
- 2011-06-15
Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 1624 N BECHTLE AVE
- City
- SPRINGFIELD OH
- Postal code
- 455041572
- Phone
- 937-523-0895
Organization contact
- Name
- SUE EDICK
- Title
- MC Assistant
- Phone
- 6788923774
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.