| NPI | 1154431807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER JOHN RUSSO Physician Assistant Certified 330-724-7715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 284300000X Special Hospital (Licence: OH 448) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |