| NPI | 1184370751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA ANN OBERBROECKLING Co Owner/Provider 937-609-1798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2022-02-23 |
| Last Update Date | 2022-02-23 |