Healthcare Provider Details
I. General information
NPI: 1194001669
Provider Name (Legal Business Name): MUNTEAN HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/28/2011
Last Update Date: 10/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26 E PARK DR STE 105
ATHENS OH
45701-5003
US
IV. Provider business mailing address
26 E PARK DR STE 105
ATHENS OH
45701-5003
US
V. Phone/Fax
- Phone: 740-592-4229
- Fax:
- Phone: 740-592-4229
- Fax: 740-592-4010
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
NICHOLAS
MUNTEAN
Title or Position: OWNER
Credential:
Phone: 740-592-4229