| NPI | 1124376108 |
|---|---|
| Doing Business As | GCH PHYSICIAN PRACTICE GAIUS STREET |
| Entity Type | Organization |
| Authorized Contact | DONALD E DRAIME Vice President/CFO 419-468-0501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2012-08-22 |
| Last Update Date | 2014-03-26 |