| NPI | 1053431130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELEANOR J HOST Owner 419-872-3250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OH 35065656) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2015-07-29 |