| NPI | 1104123595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS E VIOLAND Owner 330-491-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 34.001130) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: OH 34.001130) |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2011-02-21 |