| NPI | 1093892028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILIAN A WAITE President 937-436-3833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35-074883) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-08-27 |