| NPI | 1023372448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKY DONALD ST ONGE Sole Member 740-645-3893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OH 35-066328) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2014-11-12 |