| NPI | 1134536584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL C BOURLAND President 614-442-2431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2014-07-17 |