NPI | 1043529696 |
---|---|
Entity Type | Organization |
Authorized Contact | LORI MCCUNE Credentialing Coordinator 419-824-7264 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine |
Enumeration Date | 2010-09-30 |
Last Update Date | 2010-09-30 |