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419-647-4584. — NPI 1750686770, Spencerville, OH | NPI Central

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NPI 1750686770

OrganizationActive

419-647-4584.

NPI 1750686770 · Point of Service · Spencerville, OH

Provider details

NPI number: 1750686770
Entity type: Organization
Primary specialty: Point of ServiceManaged Care Organizations
Parent organization: No
Authorized official: Cathy Bates, Student
License: 788776765655 (OH)

Practice location

102 S Broadway St

Spencerville, OH 45887-1267

Phone: (614) 582-9253

More OH providers

Mailing address

102 S Broadway St

Spencerville, OH 45887-1267

Registry dates

Enumerated: 2011-01-23
Last updated: 2011-01-23

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.