| NPI | 1053565986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN FILBERT Owner 330-416-6153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2015-03-26 |