PREMISE HEALTH OF OHIO MEDICAL P.A NPI 1912570821

NPI Information

PREMISE HEALTH OF OHIO MEDICAL, P.A is a multi-specialty clinic center in Beavercreek, OH. PREMISE HEALTH OF OHIO MEDICAL, P.A NPI is 1912570821. The provider is registered as an organization entity type.
The provider Is Doing Business As Butler Advantage - Beavercreek.

The provider's business location address is:

3040 KEMP RD STE 100
BEAVERCREEK, OH
ZIP 45431-644
Phone: (248) 837-2625
Fax: (248) 837-2682

The provider's authorized official is Jonathan B Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 36D2183230 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/19/2021 and was last updated on 8/16/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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