| NPI | 1073971453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW MCDANIEL Managing Member 330-835-4545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2016-02-01 |