Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 35.094315 | OH |
NPI | 1194908806 |
---|---|
Provider Name | Clinton A. Hartz |
First Address | Chillicothe, OH 45601-9031 |
Second Address | Chillicothe, OH 45601-9031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2007 |
Last Update Date | 23/12/2021 |