Healthcare Provider Details
I. General information
NPI: 1689548125
Provider Name (Legal Business Name): ALLIED CORRECTIONAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/29/2025
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
810 W 2ND ST UNIT A
WAVERLY OH
45690-9433
US
IV. Provider business mailing address
PO BOX 14
URBANA OH
43078-0014
US
V. Phone/Fax
- Phone: 937-629-7411
- Fax: 937-365-9008
- Phone: 937-629-7411
- Fax: 937-365-9008
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SEAN
STILTNER
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: D.O.
Phone: 740-352-7733