| NPI | 1033173711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO ELLEN BRADEN Administrator 937-642-6622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OH 0751AS) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2008-03-19 |