| NPI | 1114299104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY ROBERT HUSTON President 440-593-6551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 34-00-4562) |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2012-02-06 |