| NPI | 1013781541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE STATES Director Of Operations/ Compliance 330-564-8681 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2023-11-15 |