| NPI | 1194072306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIANE F TCHAOUTCHOUA Lpn 614-732-3089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: OH 148425) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-08-07 |