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General NPI Number Information
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NPI Number | 1598719817
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Entity Type | Organization
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Legal Business Name | LIMA MEMORIAL PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 04/09/2022
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Provider Practice Location Address
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Address Line | 602 W REDSKIN TRL
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City | WAPAKONETA
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State | OH
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Zip | 45895-9349
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Country | US
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Telephone | 419-738-5151
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Fax | 419-941-1092
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Provider Business Mailing Address
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Address Line | 1001 BELLEFONTAINE AVE
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City | LIMA
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State | OH
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Zip | 45804-2800
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Country | US
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Telephone | 419-998-4575
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Fax | 419-998-4586
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Authorized Official
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Title or Position | DIRECTOR OF LMP
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Name | JEFFREY UTZ
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Credential |
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Telephone | 419-998-4668
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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 |
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License Number State |
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