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General NPI Number Information
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NPI Number | 1750942504
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Entity Type | Organization
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Legal Business Name | QUALITY CARE ASSOCIATES URGENT CARE AND WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 06/24/2019
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Provider Practice Location Address
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Address Line | 416 FRONT ST
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City | MARIETTA
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State | OH
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Zip | 45750-2124
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Country | US
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Telephone | 740-516-6062
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Fax |
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Provider Business Mailing Address
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Address Line | 416 FRONT ST
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City | MARIETTA
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State | OH
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Zip | 45750-2124
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Country | US
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Telephone | 469-217-4118
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEFF A PATEY
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Credential |
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Telephone | 740-516-6062
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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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