| NPI | 1043216914 |
|---|---|
| Doing Business As | EAST AVENUE FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | KATHERINE LILLY RICHMOND President 330-475-7535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2022-07-21 |