| NPI | 1063849016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY C BARKLEY Agent/Owner 330-206-2063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OH 19090) |
| Enumeration Date | 2013-10-07 |
| Last Update Date | 2013-10-07 |