Promedica Central Physicians, LLC

NPI #1114112273 in Defiance, Ohio

Provider Information

NPI Number: 1114112273
Entity Type: Organization
Organization Name: Promedica Central Physicians, LLC
Primary Specialty: Otolaryngology
Enumeration Date: Sep 12, 2007
Last Updated: Feb 18, 2008

Practice Location

Address: 1200 RALSTON AVE
City: Defiance
State: Ohio
ZIP Code: 43512-1396
Phone: (419) 783-6847

Authorized Official

Name: KIMBERLY GOVAN
Title: CREDENTIALING SUPERVISOR
Phone: (419) 824-7221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Otolaryngology	207Y00000X	Primary

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