Basic Information
| Provider Information | |||||||||
| NPI: | 1194001669 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MUNTEAN HEALTH CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26 E PARK DR STE 105 | ||||||||
| Address2: | |||||||||
| City: | ATHENS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 457015003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405924229 | ||||||||
| FaxNumber: | 7405924010 | ||||||||
| Practice Location | |||||||||
| Address1: | 26 E PARK DR STE 105 | ||||||||
| Address2: | |||||||||
| City: | ATHENS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 457015003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7405924229 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2011 | ||||||||
| LastUpdateDate: | 10/17/2018 | ||||||||
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| AuthorizedOfficialLastName: | MUNTEAN | ||||||||
| AuthorizedOfficialFirstName: | NICHOLAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7405924229 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 111N00000X | N | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor | 208D00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 0062554 | 05 | OH | MEDICAID |