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General NPI Number Information
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NPI Number | 1093774242
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Entity Type | Organization
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Legal Business Name | WASHINGTON CO
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 342 MUSKINGUM DR
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City | MARIETTA
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State | OH
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Zip | 45750
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Country | US
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Telephone | 740-374-2782
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Fax | 740-376-5810
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Provider Business Mailing Address
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Address Line | 342 MUSKINGUM DR
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City | MARIETTA
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State | OH
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Zip | 45750
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Country | US
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Telephone | 740-374-2782
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Fax | 740-376-5810
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOHN COURTNEY WITSCHEY
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Credential |
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Telephone | 740-374-2782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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