| NPI | 1093920506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN FRANCIS DITRAGLIA Owner 740-354-6605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OH 35047660) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: OH 35047660) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2019-03-18 |