| NPI | 1104923549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY C ELLIOTT Executive Director 740-420-8078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OH 35022815M) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |