UPI (Provider ID): 12448
Change Report (if Any):

Short Name: OH DGNSTC TREAT

Long Name 1: THE OHIO DIAGNOSTIC TREATMENT
Long Name 2: CENTER FOR THE DISABLED

Address 1: 6502 EAST MAIN STREET
Address 2:

City: REYNOLDSBURG
Zip Code: 43068
County: FRAN

Contact: CARMINE NARDIS
Title: CEO
Phone: 6148922473
FAX: 6147554410

Vendor: 12448

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012