Healthcare Provider Details

I. General information

NPI: 1235418328
Provider Name (Legal Business Name): MUSKINGUM VALLEY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2011
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

859 NORTH MAIN STREET
MALTA OH
43758-9007
US

IV. Provider business mailing address

859 NORTH MAIN STREET
MALTA OH
43758-9007
US

V. Phone/Fax

Practice location:
  • Phone: 740-962-6111
  • Fax: 740-962-2182
Mailing address:
  • Phone: 740-962-6111
  • Fax: 740-962-2182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DANIEL ATKINSON
Title or Position: CEO
Credential:
Phone: 740-891-9090