Conitaca Medical Associates LLC
Restricted
Conitaca Medical Associates LLC is subject to Restricted. See the individual lists below.
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Address
17674 Mahoning Avenue,Suite B,Lake Milton,Ohio,44429
ID Details
ID NUMBER : 0083622
ID TYPE : Provider ID
ID NUMBER : 1477742716
ID TYPE : Npi
View Notes
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Conitaca Medical Associates LLC Sanctioned By Below Authority
| List Name | List Authority | Effective Date ▼ | Status |
|---|---|---|---|
| The Ohio Department of Medicaid (ODM) | Sep 2, 2023 | active |
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