| NPI | 1023365749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUDOLPH KRAFT Program Director 330-480-3631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OH 57.021131) |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2012-08-13 |