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General NPI Number Information
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NPI Number | 1427085273
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Entity Type | Organization
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Legal Business Name | V CLEW, LLC
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | 1201 RIVER VALLEY BLVD
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City | LANCASTER
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State | OH
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Zip | 43130-1659
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Country | US
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Telephone | 740-687-2273
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Fax | 740-687-9059
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Provider Business Mailing Address
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Address Line | 1201 RIVER VALLEY BLVD
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City | LANCASTER
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State | OH
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Zip | 43130-1659
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Country | US
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Telephone | 740-687-2273
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Fax | 740-687-9059
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MRS. TINA MARIE ANDERSON
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Credential |
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Telephone | 740-687-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1472340
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License Number State | OH
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