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General NPI Number Information
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NPI Number | 1568676138
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Entity Type | Organization
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Legal Business Name | OHIO UNIVERSITY
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | OHIO UNIVERSITY HERITAGE COLLEGE OF OSTEOPATHIC MEDICIN GROSVENOR HALL 057
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City | ATHENS
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State | OH
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Zip | 45701-2979
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Country | US
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Telephone | 740-593-9364
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Fax | 740-593-9536
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Provider Business Mailing Address
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Address Line | OHIO UNIVERSITY HERITAGE COLLEGE OF OSTEOPATHIC MEDICIN GROSVENOR HALL 057
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City | ATHENS
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State | OH
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Zip | 45701-2979
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Country | US
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Telephone | 740-593-9364
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Fax | 740-593-9536
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Authorized Official
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Title or Position | DIRECTOR-COMMUNITY HEALTH PROGRAMS
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Name | MS. KATHLEEN JOYCE TRACE
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Credential | RN
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Telephone | 740-593-9364
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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 |
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License Number State |
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