| NPI | 1205134723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON BUPP Owner 330-336-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OH 35082293) |
| Enumeration Date | 2011-03-08 |
| Last Update Date | 2014-01-14 |