Richard D Watkins Canton Community Clinic, Inc.

NPI #1720289903 in Canton, Ohio

Provider Information

NPI Number: 1720289903
Entity Type: Organization
Organization Name: Richard D Watkins Canton Community Clinic, Inc.
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: May 29, 2007
Last Updated: May 8, 2008

Practice Location

Address: 2725 LINCOLN ST E
City: Canton
State: Ohio
ZIP Code: 44707-2769
Phone: (330) 454-2000

Authorized Official

Name: PENNY A GEMBAROSKY
Title: CHIEF FINANCIAL OFFICER
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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