Richard D Watkins Canton Community Clinic, INC

NPI #1619319043 in Canton, Ohio

Provider Information

NPI Number: 1619319043
Entity Type: Organization
Organization Name: Richard D Watkins Canton Community Clinic, INC
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: Jul 26, 2013
Last Updated: Jul 14, 2014

Practice Location

Address: 3015 MAHONING RD NE
City: Canton
State: Ohio
ZIP Code: 44705-3335
Phone: (330) 454-2000

Authorized Official

Name: DAVID COLA, DO
Title: CEO
Phone: (330) 454-2000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X	Primary

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