| NPI | 1023517331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE WEAVER Reimbursement Specialist 740-216-4552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2018-02-02 |
| Last Update Date | 2018-02-06 |