| NPI | 1104181338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL PETRICK Owner 440-879-1108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH COA.10757-NP) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2024-02-19 |