Healthcare Provider Details

I. General information

NPI: 1710441183
Provider Name (Legal Business Name): TRUE HOLISTIC PRIMARY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5797 BEECHCROFT RD STE F
COLUMBUS OH
43229-2758
US

IV. Provider business mailing address

5797 BEECHCROFT RD STE F
COLUMBUS OH
43229-2758
US

V. Phone/Fax

Practice location:
  • Phone: 614-795-3768
  • Fax:
Mailing address:
  • Phone: 614-795-3768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KAWSU CONTEH
Title or Position: CEO
Credential: CNP
Phone: 614-795-3768