| NPI | 1063831303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY R HECKER CFO 330-438-6352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-09-12 |