Provider Demographics
NPI:1134270523
Name:NELSONVILLE FAMILY PRACTICE CENTER, INC
Entity type:Organization
Organization Name:NELSONVILLE FAMILY PRACTICE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HOLTEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:740-753-4436
Mailing Address - Street 1:222 MYERS ST
Mailing Address - Street 2:
Mailing Address - City:NELSONVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45764-1238
Mailing Address - Country:US
Mailing Address - Phone:740-753-4436
Mailing Address - Fax:740-753-4749
Practice Address - Street 1:222 MYERS ST
Practice Address - Street 2:
Practice Address - City:NELSONVILLE
Practice Address - State:OH
Practice Address - Zip Code:45764-1238
Practice Address - Country:US
Practice Address - Phone:740-753-4436
Practice Address - Fax:740-753-4749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH363830261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health