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General NPI Number Information
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NPI Number | 1629791900
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH & WELLNESS PARTNERS OF LOGAN COUNTY
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Dates
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Enumeration Date | 09/22/2022
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 8920 COUNTY ROAD 91 STE 2
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City | LEWISTOWN
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State | OH
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Zip | 43333-9786
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Country | US
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Telephone | 937-599-1411
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Fax | 937-599-4128
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Provider Business Mailing Address
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Address Line | 212 E COLUMBUS AVE STE 1
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-2033
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Country | US
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Telephone | 937-599-1411
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Fax | 937-599-4128
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Authorized Official
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Title or Position | CEO
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Name | TARA DAWN BAIR
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Credential |
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Telephone | 937-599-1411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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