NPI 1023423571

Independent Provider

Organisation Preferred Provider Organization Columbus, OH

Practice location

Address: 3664 Larkwell Way, Columbus, OH 43232-3611
Phone: (614) 571-5191
Mailing address: 3664 Larkwell Way, Columbus, OH 43232

Authorised official

Name: Tasshia Renee Lee
Title: Independent Provider
Phone: (614) 571-5191

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 2870880 (OH)

Other Preferred Provider Organization providers in Ohio →

Registry record

NPI: 1023423571
Entity type: Organization
NPI issued: 24 Jun 2014
Record last updated: 24 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.