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NPI Code Detail

MEDICARE: ARROWHEAD VENTURES LLC

MEDICARE: ARROWHEAD VENTURES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP3300XPain Clinic/Center33.011116OH

General Provider Information

NPI Number : 1164668406
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARROWHEAD VENTURES LLC
Provider Business Mailing Address
First Line : 1514 REYNOLDS RD
Second Line :
City : MAUMEE
State : OH
Zip : 43537-1692
Country : US
Telephone Number : 419-887-1880
Fax Number : 419-887-1880
Provider Business Practice Location Address
First Line : 1514 REYNOLDS RD
Second Line :
City : MAUMEE
State : OH
Zip : 43537-1692
Country : US
Telephone Number : 419-887-1880
Fax Number : 419-887-1880
Authorized Official
Title or Position : OWNER
Name : MARY ANN MCGILL
Credential : LMT
Telephone Number : 419-887-1880
Provider Enumeration Date : 12/16/2008
Last Update Date : 12/16/2008

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Directions to “ARROWHEAD VENTURES LLC ” Practice Location

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