| NPI | 1104262906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SVETLANA STAHL Owner 419-699-1907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.121135) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2024-06-18 |