| NPI | 1184174682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON EDWARD STURGEON Medication Therapy Clinic Manager 220-564-1898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OH 03325440) |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-10-07 |