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General NPI Number Information
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NPI Number | 1528309663
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Entity Type | Organization
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Legal Business Name | CTR MEDICAL CENTER
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Dates
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Enumeration Date | 03/14/2013
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Last Update Date | 03/14/2013
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Provider Practice Location Address
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Address Line | 305 UPPER RIVER RD
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City | GALLIPOLIS
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State | OH
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Zip | 45631-8020
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Country | US
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Telephone | 740-441-5138
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Fax | 888-442-4167
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Provider Business Mailing Address
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Address Line | 305 UPPER RIVER RD
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City | GALLIPOLIS
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State | OH
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Zip | 45631-8020
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Country | US
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Telephone | 740-441-5138
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Fax | 888-442-4167
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Authorized Official
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Title or Position | PRESIDENT
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Name | HEATHER D ROBINSON
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Credential |
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Telephone | 740-441-5138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34007332
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License Number State | OH
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