| NPI | 1124079769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY LYNN JONES Credentialing Specialist 440-684-8871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology Facial Plastic Surgery |
| Additional Taxonomies | 261QH0700X Clinic/Center Hearing and Speech |
| 207KA0200X Allergy & Immunology Allergy | |
| 207Y00000X Otolaryngology | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-02-22 |