| NPI | 1063539260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY L HALL President 216-881-5055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OH 35063967) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2014-03-10 |