| NPI | 1053679100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBI NOLAN Follow Up Specialist/Credentialing 740-772-7909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2023-04-26 |