| NPI | 1083799357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE RENEE GRAWE Billing Specialist 937-681-5740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35067724) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2008-08-13 |