Main Street Medical Center of Crestview, PA

NPI #1619181914 in Crestview, Florida

Provider Information

NPI Number: 1619181914
Entity Type: Organization
Organization Name: Main Street Medical Center of Crestview, PA
Primary Specialty: Internal Medicine
Enumeration Date: May 9, 2007
Last Updated: Jun 21, 2018

Practice Location

Address: 369 N. MAIN ST.
City: Crestview
State: Florida
ZIP Code: 32536-3541
Phone: (850) 398-6963

Authorized Official

Name: JOSHUA K. KOLMETZ, MD
Title: OWNER
Phone: (850) 398-6963

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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