| NPI | 1033431507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVERETT JAN WILSON Physician 740-574-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OH 34-002236) |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2010-02-24 |