| NPI | 1043427966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY PATRICK WETHERINGTON President 937-393-6481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OH 35073826) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |