| NPI | 1063692341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES D HANSHAW President 937-439-7430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34003234H) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 009141) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2009-06-30 |