| Mantua Family Healthcare | |
|
6693 N Chestnut St 10a&b Ravenna OH 44266-3922 | |
| (419) 861-3451 | |
| (419) 861-3451 |
| Full Name | Mantua Family Healthcare |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 6693 N Chestnut St, Ravenna, Ohio |
| Authorized Official Name and Position | Ann C Weldy (OFFICE MANAGER) |
| Authorized Official Contact | 4198613451 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mantua Family Healthcare Po Box 140333 Toledo OH 43614-0333 Ph: (419) 861-3451 | Mantua Family Healthcare 6693 N Chestnut St 10a&b Ravenna OH 44266-3922 Ph: (419) 861-3451 |
| NPI Number | 1588862163 |
|---|---|
| Provider Enumeration Date | 07/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588862163 | NPI | - | NPPES |
| 000000134223 | Other | OH | ANTHEM |
| 01594 | Other | OH | FAA |
| 100766 | Other | OH | KAISER |
| Q015911A | Other | OH | HOMETOWN |
| 0649249 | Medicaid | OH | |
| 314502699-00 | Other | OH | BWC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | 35052329W (Ohio) | Primary |
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