Healthcare Provider Details

I. General information

NPI: 1447342795
Provider Name (Legal Business Name): MUSKINGUM TB & RESPIRATORY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 MAIN ST
ZANESVILLE OH
43701-3731
US

IV. Provider business mailing address

711 MAIN ST
ZANESVILLE OH
43701-3731
US

V. Phone/Fax

Practice location:
  • Phone: 740-452-5401
  • Fax: 740-452-4493
Mailing address:
  • Phone: 740-452-5401
  • Fax: 740-452-4493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. PEGGY ORECCHIO
Title or Position: APPOINTED INTERIM DIRECTOR
Credential:
Phone: 740-452-5401