| NPI | 1124142120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY JASON SMITH None Agency Nurses Aide 740-213-0567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2020-08-22 |