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General NPI Number Information
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NPI Number | 1396938791
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Entity Type | Organization
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Legal Business Name | OHIO INSTITUTE OF CARDIAC CARE, INC
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 1117 E HOME RD
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City | SPRINGFIELD
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State | OH
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Zip | 45503-2725
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Country | US
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Telephone | 937-390-8100
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Fax | 937-390-8109
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Provider Business Mailing Address
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Address Line | 1117 E HOME RD
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City | SPRINGFIELD
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State | OH
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Zip | 45503-2725
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Country | US
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Telephone | 937-390-8100
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Fax | 937-390-8109
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Authorized Official
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Title or Position | CREDENTIALINC COORDINATOR
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Name | MS. PATRICIA DIETZ BRASSE
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Credential |
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Telephone | 937-429-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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