| NPI | 1114720091 |
|---|---|
| Doing Business As | PRIMARY ONE |
| Entity Type | Organization |
| Authorized Contact | BONA LEE Sole Owner/Authorized Official 614-307-2637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2025-04-09 |