| NPI | 1205175387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON VERON BROWN Manager 937-461-8933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OH 35038418) |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2013-02-08 |