| NPI | 1043557390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTA J SHRIVER Owner 740-577-3132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA12752) |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2013-01-07 |