| NPI | 1104818038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE STONE Administrator 330-668-4085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OH 0102AS-153) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2008-04-20 |