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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Conitaca Medical Associates, LLC | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States | [sources] | |||
| Description | Provider ID: 0083622 | [sources] | |||
| NPI | 1477742716 | [sources] | |||
| Registration number | not available | [sources] | |||
| Sector | 21-Professional Medical Group | [sources] | |||
| Address | 17674 Mahoning Avenue, Suite B, Lake Milton, OH 44429 | [sources] | |||
| Last change | Last processed | First seen | |||
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| Address | ||
|---|---|---|
| Full address | Country | |
| 17674 Mahoning Avenue, Suite B, Lake Milton, OH 44429 | United States | |