| NPI | 1073542916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CHASTAIN Director Of Provider Enrollment 330-493-4443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2025-02-12 |