| NPI | 1184703969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE J LISOTTO Administrative Director 330-759-7672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2008-05-02 |