| NPI | 1144892472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY MAUREY Credentialing Specialist 614-274-1455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2023-06-08 |